Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2017; 8(12): 922-928
Published online Dec 18, 2017. doi: 10.5312/wjo.v8.i12.922
Evaluation of 1031 primary titanium nitride coated mobile bearing total knee arthroplasties in an orthopedic clinic
Stefan J M Breugem, Jeroen Linnartz, Inger Sierevelt, Jon D Bruijn, Marcel J M Driessen
Stefan J M Breugem, Jeroen Linnartz, Jon D Bruijn, Marcel J M Driessen, Orthopedium, Orthopedic Clinic, Delft 2616 LS, The Netherlands
Inger Sierevelt, Slotervaart Hospital, Amsterdam 1066 EC, The Netherlands
Author contributions: All authors equally contributed to this article; Breugem SJM and Linnartz J wrote the paper, analysed the data; Sierevelt I evaluated the data, performed a critical review and did the final approval; Breugem SJM, Bruijn JD and Driessen MJM designed the study and performed the critical revision and editing and performed the final approval of the final version.
Institutional review board statement: This was not necessary seeing that is a retrospective case series.
Informed consent statement: All the patients included in the study gave an informed consent.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Data sharing statement: The authors are willing to share the data of the present study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Stefan J M Breugem, MD, PhD, Orthopedium, Orthopedic Clinic, Olof Palmesstraat 20, Delft 2616 LS, The Netherlands. sbreugem@orthopedium.nl
Telephone: +31-8-80088444 Fax: +31-8-80088445
Received: August 5, 2017
Peer-review started: August 7, 2017
First decision: September 4, 2017
Revised: October 25, 2017
Accepted: November 10, 2017
Article in press: November 10, 2017
Published online: December 18, 2017
Processing time: 134 Days and 7.4 Hours
Abstract
AIM

To evaluate the influence of the titanium nitride (TiN) coating on the results of a total knee arthroplasty (TKA).

METHODS

A total of 910 patients (338 men; 572 woman), with a mean age of 65 (range 36-94) undergoing 1031 primary TKAs were assessed. Clinical evaluation and patient-reported outcomes were gathered one year after surgery. The questionnaires included the Knee injury and Osteoarthritis Outcome Score (KOOS)-Dutch version, Visual Analogue Scale (VAS) pain scores in rest and during active knee movement, VAS-satisfaction scores, and EQ-5D-3L health scores. This was aimed to assess the overall knee function and patient satisfaction, and to enable us to make a gross comparison to other TKAs.

RESULTS

At a mean follow-up of 46 mo (range 1-92) the overall implant survival was 97.7% and 95.1% for any operative reason related to the implant. Twenty-three knees (2.2%) required revision surgery. Arthrofibrosis was the most common indication for a re-operation. The clinical evaluation and patient-reported outcomes revealed good to excellent patient satisfaction and function of the arthroplasty. The median postoperative VAS-pain scores on a scale of 0-100, at one year after surgery were 1 in rest and 2 during movement.

CONCLUSION

The TiN coated, mobile bearing TKA results are excellent and similar to those of other widely used TKA designs. Residual pain of the knee remains a concern and the TiN coating in combination with the mobile bearing does not seem to be the simple solution to this problem. Future research will have to show that the coating gives a better survival than the cobalt chrome version.

Keywords: Total knee arthroplasty; Titanium nitride coating; Mobile bearing; Pain; Satisfaction and survival

Core tip: The titanium nitride coated, mobile bearing total knee arthroplasty (TKA) results are excellent and similar to those of other widely used TKA designs.