Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis
Background and purpose: Backside wear of the polyethylene insert in total knee arthroplasty (TKA) has been described to produce clinically significant levels of polyethylene debris, which can lead to aseptic loosening and osteolysis. Monoblock design eliminates backside wear of the polyethylene an...
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Medical Journals Sweden
2025-06-01
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| Series: | Acta Orthopaedica |
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| Online Access: | https://actaorthop.org/actao/article/view/43904 |
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| author | Mikkel Rathsach Andersen Müjgan Yilmaz Nikolaj Winther Thomas Lind Henrik Schrøder Gunnar FLIVIK Flivik Michael Mørk Petersen |
| author_facet | Mikkel Rathsach Andersen Müjgan Yilmaz Nikolaj Winther Thomas Lind Henrik Schrøder Gunnar FLIVIK Flivik Michael Mørk Petersen |
| author_sort | Mikkel Rathsach Andersen |
| collection | DOAJ |
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Background and purpose: Backside wear of the polyethylene insert in total knee arthroplasty (TKA) has been described to produce clinically significant levels of polyethylene debris, which can lead to aseptic loosening and osteolysis. Monoblock design eliminates backside wear of the polyethylene and therefore could improve long-term fixation. This randomized clinical trial (RCT) using radiostereometric analysis (RSA) compares micromotion of monoblock and modular polyethylene inserts with 7 years’ follow-up.
Methods: 65 patients (mean age 61 years) were randomized to receive either monoblock (n = 32) or modular (n = 33) uncemented trabecular metal tibial components. 35 patients (monoblock = 18, and modular = 17) completed 7 years’ follow-up. The primary endpoint of the study was maximum total point motion (MTPM). Implant translation and rotation are reported as secondary endpoints.
Results: After 84 months, the modular group had a statistically significant higher mean MTPM of 1.17 (95% confidence interval [CI] 0.90–1.41) mm compared with the monoblock group of 0.78 (CI 0.55–0.88) mm (P = 0.02). However, there was no difference in continuous migration (from 12–84 months), which was 0.13 mm in the monoblock group and 0.16 mm in the modular group.
Conclusion: There was significantly lower early migration in the monoblock group compared with the modular group but no difference in continuous migration after 12 months, which confirms the finding of previous publications.
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| format | Article |
| id | doaj-art-093f7c43f7ea46ccad014bb76c49d062 |
| institution | Kabale University |
| issn | 1745-3674 1745-3682 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj-art-093f7c43f7ea46ccad014bb76c49d0622025-08-20T03:31:52ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822025-06-019610.2340/17453674.2025.43904Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysisMikkel Rathsach Andersen0https://orcid.org/0000-0003-3405-7147Müjgan Yilmaz1Nikolaj Winther2Thomas Lind3Henrik Schrøder4Gunnar FLIVIK Flivik5https://orcid.org/0000-0002-6872-4174Michael Mørk Petersen6https://orcid.org/0000-0002-2324-6420Department of Orthopedics, Herlev Gentofte Hospital, University of Copenhagen; Department of Orthopedics, Rigshospitalet, University of Copenhagen, DenmarkDepartment of Orthopedics, Rigshospitalet, University of Copenhagen, DenmarkDepartment of Orthopedics, Rigshospitalet, University of Copenhagen, DenmarkDepartment of Orthopedics, Herlev Gentofte Hospital, University of Copenhagen, DenmarkDepartment of Orthopedics, Rigshospitalet, University of Copenhagen, DenmarkDepartment of Orthopedics, Skåne University Hospital, Lund University, SwedenDepartment of Orthopedics, Rigshospitalet, University of Copenhagen, Denmark Background and purpose: Backside wear of the polyethylene insert in total knee arthroplasty (TKA) has been described to produce clinically significant levels of polyethylene debris, which can lead to aseptic loosening and osteolysis. Monoblock design eliminates backside wear of the polyethylene and therefore could improve long-term fixation. This randomized clinical trial (RCT) using radiostereometric analysis (RSA) compares micromotion of monoblock and modular polyethylene inserts with 7 years’ follow-up. Methods: 65 patients (mean age 61 years) were randomized to receive either monoblock (n = 32) or modular (n = 33) uncemented trabecular metal tibial components. 35 patients (monoblock = 18, and modular = 17) completed 7 years’ follow-up. The primary endpoint of the study was maximum total point motion (MTPM). Implant translation and rotation are reported as secondary endpoints. Results: After 84 months, the modular group had a statistically significant higher mean MTPM of 1.17 (95% confidence interval [CI] 0.90–1.41) mm compared with the monoblock group of 0.78 (CI 0.55–0.88) mm (P = 0.02). However, there was no difference in continuous migration (from 12–84 months), which was 0.13 mm in the monoblock group and 0.16 mm in the modular group. Conclusion: There was significantly lower early migration in the monoblock group compared with the modular group but no difference in continuous migration after 12 months, which confirms the finding of previous publications. https://actaorthop.org/actao/article/view/43904ArthroplastyImplantsKneeOsteoarthrosis |
| spellingShingle | Mikkel Rathsach Andersen Müjgan Yilmaz Nikolaj Winther Thomas Lind Henrik Schrøder Gunnar FLIVIK Flivik Michael Mørk Petersen Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis Acta Orthopaedica Arthroplasty Implants Knee Osteoarthrosis |
| title | Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis |
| title_full | Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis |
| title_fullStr | Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis |
| title_full_unstemmed | Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis |
| title_short | Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis |
| title_sort | long term migration of monoblock vs modular design in uncemented total knee arthroplasty a secondary report of a randomized trial using radiostereometric analysis |
| topic | Arthroplasty Implants Knee Osteoarthrosis |
| url | https://actaorthop.org/actao/article/view/43904 |
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