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Knee

A COMPARISON OF THREE POSTERIOR STABILISED TOTAL KNEE REPLACEMENTS - IS DESIGN EVOLUTION MATCHED BY IMPROVED PERFORMANCE?

British Association for Surgery of the Knee (BASK)



Abstract

OBJECTIVE

To examine the short term patient assessed functional results of the Journey BCS ¯(Smith & Nephew) and Triathlon ¯(Stryker Orthopaedics, Mahwah, NJ) total knee replacements when compared to the Scorpio ¯(Stryker) total knee replacement using a multi-surgeon case control design in a single centre.

METHODS

From September 2006 to August 2008 a total of 135 Journey and 97 Triathlon total knee replacements (TKR) were performed. 105 patients with Journey and 90 patients with Triathlon implants were available for follow-up at a minimum of 1 year, with an average of 2 years. Age and sex matched controls were obtained from our pool of patients who had had Scorpio TKR's. The same surgeons using the same approach operated on patients in both groups. All implants were posterior stabilised and all underwent patella resurfacing. All patients were seen pre-operatively and followed up post operatively in a physiotherapist led joint review clinic to assess range of motion (ROM) as well as function using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS) and the High Activity Arthroplasty Score (HAAS - used post operatively only).

RESULTS

Each of the control groups was well matched with no significant differences pre-operatively. Post operatively the Journey showed statistically significant improvements in ROM over the Scorpio group with an average ROM 10 degrees higher as well as a 7 point mean difference in WOMAC score (p= 0.089). The Triathlon showed the largest mean improvement in Oxford knee score pre to post operatively of all the groups at 14.6 as well as higher HAAS and WOMAC scores than it's controls although these did not quite reach statistical significance (p = 0.068)

CONCLUSION

Compared to a matched group of Scorpio PS TKRs the Journey BCS showed a significant improvement in both range of movement and functional scores whereas the Triathlon PS showed no statistically significant change in the same parameters