title: Does pre-coating total knee tibial implants affect the risk of aseptic revision?
abstract: We evaluated the impact of pre-coating the tibial component with polymethylmethacrylate (PMMA) on implant survival in a cohort of 16 548 primary NexGen total knee replacements (TKRs) in 14 113 patients. In 13 835 TKRs a pre-coated tray was used while in 2713 TKRs the non-pre-coated version of the same tray was used. All the TKRs were performed between 2001 and 2009 and were cemented. TKRs implanted with a pre-coated tibial component had a lower cumulative survival than those with a non-pre-coated tibial component (p = 0.01). After adjusting for diagnosis, age, gender, body mass index, American Society of Anesthesiologists grade, femoral coupling design, surgeon volume and hospital volume, pre-coating was an independent risk factor for all-cause aseptic revision (hazard ratio 2.75, p = 0.006). Revision for aseptic loosening was uncommon for both pre-coated and non-pre-coated trays (rates of 0.12% and 0%, respectively). Pre-coating with PMMA does not appear to be protective of revision for this tibial tray design at short-term follow-up.
authors: Kaiser Permanente, 280 West MacArthur Blvd, Oakland, California 94611, USA. stefano.bini@kp.org
authors: S A
authors: SA
authors: Bini
authors: Y
authors: Y
authors: Chen
authors: M
authors: M
authors: Khatod
authors: E W
authors: EW
authors: Paxton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D019904:Polymethyl Methacrylate; D016016:Proportional Hazards Models; D011475:Prosthesis Failure; D012042:Registries; D012086:Reoperation; D012307:Risk Factors; D013977:Tibia; D016896:Treatment Outcome
chemical_list: D019904:Polymethyl Methacrylate