Long-term survivorship of a medial-pivot total knee system compared with other cemented designs in an arthroplasty registry

BACKGROUND: The Orthopaedic Data Evaluation Panel (ODEP) monitors the performance of primary total knee arthroplasty (TKA) implants against guidance provided by the National Institute for Health and Care Excellence (NICE) and issues ratings based upon survivorship data meeting or exceeding 95 % at 10-year follow-up. The objectives of the current study were to determine if the survivorship for the ADVANCE Medial-Pivot System in an arthroplasty registry exceeds this threshold and if its survivorship is significantly different than that of all other cemented bi-, tricompartmental, minimally stabilized, and fixed bearing TKAs in the same registry. METHODS: The database of an arthroplasty registry was searched for all TKAs performed with the subject system and all other cemented TKAs. The Kaplan-Meier survivorship for the subject system was compared to the NICE criteria and also that of all other cemented TKAs. Complication modes were also examined for the two groups. RESULTS: The 10-year survivorship for the included 506 TKAs using the subject system (96.3 %) exceeded the NICE guidelines of 95 % at 10 years. Survivorship also exceeded that of all other cemented TKAs (95.7 %) in the same registry, but the difference was not significantly different. CONCLUSIONS: The subject system was associated with survivorship that exceeds the NICE guidelines at 10 years and is similar to that of other cemented TKA systems. The use of this unique tibial insert design does not negatively impact component survivorship.