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Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty
PURPOSE: Allergy against implant materials is discussed controversially and still not fully understood. Despite these controversies, a relevant number of patients receive hypoallergenic knee implants. The aim of this study was to compare a new coating system with the standard implant in total knee a...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10049948/ https://www.ncbi.nlm.nih.gov/pubmed/35147719 http://dx.doi.org/10.1007/s00167-021-06836-w |
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author | Lützner, Jörg Beyer, Franziska Lützner, Cornelia Thomas, Peter Summer, Burkhard |
author_facet | Lützner, Jörg Beyer, Franziska Lützner, Cornelia Thomas, Peter Summer, Burkhard |
author_sort | Lützner, Jörg |
collection | PubMed |
description | PURPOSE: Allergy against implant materials is discussed controversially and still not fully understood. Despite these controversies, a relevant number of patients receive hypoallergenic knee implants. The aim of this study was to compare a new coating system with the standard implant in total knee arthroplasty (TKA). Additionally, the influence of proinflammatory cytokines on patient-reported outcome measures (PROMs) was investigated. METHODS: 120 patients without known metal allergy and without previous metal implants were included. The patients were randomized to receive a coated or standard TKA of the same knee system. 105 patients completed the 5 year follow-up. Patient-reported outcome measures (PROMs) including knee function (Oxford Knee Score, OKS), quality of life (SF36) and UCLA activity scale were assessed. Additionally, several cytokines with a possible role in implant allergy were measured in patient`s serum (IL-1beta, IL-5, IL-6, IL-8, IL-10, IP-10, IFN γ, TNF α). Group comparison was performed using Mann–Whitney U test for continuous values and chi-square test for categorical values. RESULTS: There were no differences in PROMs between both groups at any follow-up. The majority of patients demonstrated no elevation of the measured blood cytokines. The blood cytokine pattern after 5 years demonstrated no differences between study groups. There was a significant association between elevated IL-8 values and worse results in the overall OKS (p = 0.041), the OKS function component (p = 0.004), the UCLA activity scale (p = 0.007) and the physical component of SF36 (p = 0.001). CONCLUSION: There were no problems with the new coating during mid-term follow-up and no differences in PROMs between coated and standard TKA. Patients with an increased inflammatory response demonstrated worse functional results, regardless of the implant. LEVEL OF EVIDENCE: I. CLINICAL TRIAL REGISTRATION: The study protocol was registered in the US National Institutes of Health’s database (http://www.clinicaltrials.gov) registry under NCT00862511. |
format | Online Article Text |
id | pubmed-10049948 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-100499482023-03-30 Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty Lützner, Jörg Beyer, Franziska Lützner, Cornelia Thomas, Peter Summer, Burkhard Knee Surg Sports Traumatol Arthrosc Knee PURPOSE: Allergy against implant materials is discussed controversially and still not fully understood. Despite these controversies, a relevant number of patients receive hypoallergenic knee implants. The aim of this study was to compare a new coating system with the standard implant in total knee arthroplasty (TKA). Additionally, the influence of proinflammatory cytokines on patient-reported outcome measures (PROMs) was investigated. METHODS: 120 patients without known metal allergy and without previous metal implants were included. The patients were randomized to receive a coated or standard TKA of the same knee system. 105 patients completed the 5 year follow-up. Patient-reported outcome measures (PROMs) including knee function (Oxford Knee Score, OKS), quality of life (SF36) and UCLA activity scale were assessed. Additionally, several cytokines with a possible role in implant allergy were measured in patient`s serum (IL-1beta, IL-5, IL-6, IL-8, IL-10, IP-10, IFN γ, TNF α). Group comparison was performed using Mann–Whitney U test for continuous values and chi-square test for categorical values. RESULTS: There were no differences in PROMs between both groups at any follow-up. The majority of patients demonstrated no elevation of the measured blood cytokines. The blood cytokine pattern after 5 years demonstrated no differences between study groups. There was a significant association between elevated IL-8 values and worse results in the overall OKS (p = 0.041), the OKS function component (p = 0.004), the UCLA activity scale (p = 0.007) and the physical component of SF36 (p = 0.001). CONCLUSION: There were no problems with the new coating during mid-term follow-up and no differences in PROMs between coated and standard TKA. Patients with an increased inflammatory response demonstrated worse functional results, regardless of the implant. LEVEL OF EVIDENCE: I. CLINICAL TRIAL REGISTRATION: The study protocol was registered in the US National Institutes of Health’s database (http://www.clinicaltrials.gov) registry under NCT00862511. Springer Berlin Heidelberg 2022-02-11 2023 /pmc/articles/PMC10049948/ /pubmed/35147719 http://dx.doi.org/10.1007/s00167-021-06836-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Knee Lützner, Jörg Beyer, Franziska Lützner, Cornelia Thomas, Peter Summer, Burkhard Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty |
title | Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty |
title_full | Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty |
title_fullStr | Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty |
title_full_unstemmed | Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty |
title_short | Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty |
title_sort | increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty |
topic | Knee |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10049948/ https://www.ncbi.nlm.nih.gov/pubmed/35147719 http://dx.doi.org/10.1007/s00167-021-06836-w |
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