MedPath

Outcome Study of Highly-cross Linked Polyethylene vs. Standard Polyethylene for Primary Posterior Stabilized (PS) Total Knee

Conditions
Arthroplasty, Replacement, Knee
Interventions
Device: knee arthroplasty, standard polyethylene
Device: knee arthroplasty, XLP polyethylene
Registration Number
NCT02178020
Lead Sponsor
Chapel Hill Orthopedics Surgery & Sports Medicine
Brief Summary

Polyethylene wear and osteolysis remain a concern with the use of modular, fixed bearing total knee arthroplasty. A variety of highly cross-linked polyethylenes have been introduced to decrease this problem, but there is little data on the results and complications of this polyethylene in posterior-stabilized knee prosthesis. The investigators asked the following questions: (1) Are there any differences in the clinical and radiographic results when a highly cross-lined polyethylene is compared to a standard liner? (2) What is the frequency of reoperation in these two groups and are there any specific complications related to highly cross-linked polyethylene liners.

Detailed Description

This prospective, randomized study will seek to enroll patients undergoing primary total knee arthroplasty. Preoperative evaluation will include a detailed history and physical exam with clinical data collection (SF-36, WOMAC, and Knee Society Scores), a complete description of the procedure, a demonstration of the actual types of implants and tibial inserts, and an outline of the study protocol and informed consent. Intraoperatively, the patient will undergo a total knee arthroplasty utilizing standard operative procedures. Each patient will receive a Zimmer NexGen posterior-stabilized total knee arthroplasty. During the procedure or preoperative visit, the patient will be randomized by sealed envelope to receive either a standard Zimmer UHMWPE tibial insert or a Zimmer highly cross-linked UHMWPE tibial insert. Both surgeon and patient will be blinded to the type of implant used. there will be no variations in surgical technique and hospital management of the patients throughout the course of the study. Postoperatively, the patient will be seen for routine follow-up at six weeks, 6 months, 1 year and yearly thereafter. Radiographs will be obtained at each visit. Clinical data forms will be completed at each visit. At the conclusion of the study radiographs will be assessed for signs of polyethylene wear, osteolysis and component loosening. the preoperative and postoperative knee scores will be calculated for each patient and compared between the patient groups with standard statistical analysis.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
500
Inclusion Criteria
  • all patients indicated for primary total posterior stabilized knee arthroplasty
Exclusion Criteria
  • patients who refused participation
  • patients who did not comprehend the English language to give informed consent
  • patients with severe knee deformity thought to require a primary constrained condylar prosthesis

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
knee arthroplasty, standard polyethyleneknee arthroplasty, standard polyethylenetotal knee arthroplasty with Standard Compression Molded tibial Polyethylene Liner
knee arthroplasty, Highly Cross-Linked (XLP) polyethyleneknee arthroplasty, XLP polyethyleneknee arthroplasty with Highly Cross-Linked tibial Polyethylene Liner
Primary Outcome Measures
NameTimeMethod
Number of Participants requiring revision, or with Device Related Serious Adverse EventsUp to 10 years

reoperation rate; polyethylene fracture/failure rate

Radiographic osteolysisup to 10 years

lucent, periarticular lesions , related to polyethylene wear

Secondary Outcome Measures
NameTimeMethod
knee scoresup to 10 years

Knee Society Pain and Function scores

knee joint effusionup to 10 years

knee joint examination

Trial Locations

Locations (1)

Chapel Hill Orthopedic Surgery and Sports Medicine

🇺🇸

Chapel Hill, North Carolina, United States

© Copyright 2025. All Rights Reserved by MedPath