title: Outcomes of Newer Generation Cementless Total Knee Arthroplasty: Beaded Periapatite-Coated vs Highly Porous Titanium-Coated Implants.
abstract: Newer generation cementless total knee arthroplasty (TKA) designs are available and have novel implant coatings. We evaluated and compared beaded periapatite (PA)-coated vs highly porous titanium-coated cementless TKAs. Specifically, we compared: (1) survivorship, (2) Knee Society Scores (KSSs) and range of motion, (3) complications, and (4) radiographic findings.
  
  
  
  There were 805 TKAs with beaded PA-coated tibial and patellar components (PA group; mean age 67 years; range 41-86 years), and 219 TKAs with highly porous titanium-coated tibial and patella components (mean age 66 years; range 34-88 years). Mean follow-up was 4.4 years (range 2-9 years; median 4 years). Implant survivorship was calculated using Kaplan-Meier curves. Student t-tests and chi-square tests were used as appropriate. Radiographic evaluation was performed using Knee Society Roentgenographic Evaluation and Scoring System.
  
  
  
  All-cause implant survivorship in beaded PA-coated group was 99.5% (95% CI, 97.9%-99.9%) and 99.5% (95% CI, 92.7%-99.9%) in highly porous titanium-coated group. There were no significant differences in the KSS for pain and function. Improvement in flexion and extension was similar in the 2 groups. Overall, complication rate (2.2% vs 2.3%; P = .274) and number of revisions (6 [0.8%] vs 2 [0.2%]; P = .936) were similar in the 2 groups. Excluding the aseptic and septic failures, there were no progressive radiolucencies or osteolysis on radiographic evaluation.
  
  
  
  This study has shown good clinical and patient-reported outcomes of cementless TKA for both implants. Future multicenter large scale clinical and cost-effectiveness studies are needed to determine the superiority of one cementless implant type over the other.
authors.affiliation: Department of Orthopaedic Surgery, Mount Sinai Beth Israel Medical Center, New York, New York.
authors.forename: Steven F
authors.initials: SF
authors.lastname: Harwin
authors.affiliation: Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Nirav K
authors.initials: NK
authors.lastname: Patel
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Morad
authors.initials: M
authors.lastname: Chughtai
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Anton
authors.initials: A
authors.lastname: Khlopas
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Prem N
authors.initials: PN
authors.lastname: Ramkumar
authors.affiliation: Department of Orthopaedic Surgery, Holy Cross Orthopedic Institute, Fort Lauderdale, Florida.
authors.forename: Martin
authors.initials: M
authors.lastname: Roche
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D017886:Durapatite; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000601:surgery; D016062:Porosity; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery; D014025:Titanium
chemical_list: D017886:Durapatite; D014025:Titanium
keywords: cementless; implant coating; periapatite; titanium; total knee arthroplasty