PMID- 30836393 OWN - NLM STAT- MEDLINE DCOM- 20201110 LR - 20201110 IS - 1938-2480 (Electronic) IS - 1538-8506 (Linking) VI - 33 IP - 5 DP - 2020 May TI - Efficacy of a Second-Generation Rotating Bearing Tibial Platform in Total Knee Arthroplasty: A Prospective Observational Cohort Study with Registry Analysis. PG - 513-524 LID - 10.1055/s-0039-1678679 [doi] AB - There is a lack of clinical outcomes reported for the rotating bearing knee (RBK) total knee arthroplasty (TKA), which is a second-generation rotating platform knee, with purported benefits over earlier versions. The purpose of the study was to report the complications, short-term (minimum 1 year) patient-reported outcomes and long-term (up to 15 years) procedure survival in a consecutive series of patients receiving a rotating platform TKA (RBK) from an independent clinic. A retrospective analysis of a single-surgeon, private/public practice, with prospectively collected data in a subset of patients were performed. A total of 1,130 procedures (primary, revision from unicompartmental knee arthroplasty (UKA) to TKA) were crossmatched with manufacturer records. Clinical outcomes (complications, reoperations) were summarized and linked to patient-reported outcome measures (Eq. 5D, KSS-function, Oxford knee score [OKS]). OKS results were classified using minimally clinical important difference (MCID) and patient acceptable symptom state (PASS). PROMs were summarized and regression models used to determine relationships between patient factors and outcomes in this cohort. Cumulative percent revision was reported by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) and compared between the senior author and national data using Kaplan-Meier survival analysis. We report a complication rate of 19.7% with the majority (> 60%) being thromboembolic events and complaints of stiffness. Significant improvements were observed in general health, knee pain, and function with > 89% exceeding the MCID for the OKS and > 65% exceeding the PASS for the OKS at an average follow-up of 3.2 years. We report a cumulative revision rate of 4.3% at 5 years and 4.8% at 14 years, with significantly lower revision rates in females and patients aged 55 to 64 years compared with AOANJRR data for fixed bearing designs. The RBK rotating platform TKA provides good functional outcomes, with relatively low revision and complications rates at up to 14 years follow-up. This design in conjunction with a gap balancing technique may be advantageous in certain patient subgroups. CI - Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. FAU - Scholes, Corey AU - Scholes C AUID- ORCID: 0000-0001-6592-0738 AD - EBM Analytics, Sydney, New South Wales, Australia. FAU - Ebrahimi, Milad AU - Ebrahimi M AD - EBM Analytics, Sydney, New South Wales, Australia. FAU - Ektas, Nalan AU - Ektas N AD - EBM Analytics, Sydney, New South Wales, Australia. FAU - Ireland, John AU - Ireland J AD - Sydney Bone and Joint Clinic, Campbelltown, New South Wales, Australia. LA - eng PT - Journal Article PT - Observational Study DEP - 20190305 PL - Germany TA - J Knee Surg JT - The journal of knee surgery JID - 101137599 SB - IM MH - Aged MH - Arthroplasty, Replacement, Knee/*instrumentation/methods MH - Female MH - Humans MH - *Knee Prosthesis MH - Male MH - Middle Aged MH - Osteoarthritis, Knee/*surgery MH - Patient Reported Outcome Measures MH - Range of Motion, Articular MH - Registries MH - Reoperation MH - Retrospective Studies MH - Tibia/surgery MH - Treatment Outcome COIS- J. I. reports personal fees from Activ Surgical P/L, outside the submitted work. All the other authors report no conflict of interest. EDAT- 2019/03/06 06:00 MHDA- 2020/11/11 06:00 CRDT- 2019/03/06 06:00 PHST- 2019/03/06 06:00 [pubmed] PHST- 2020/11/11 06:00 [medline] PHST- 2019/03/06 06:00 [entrez] AID - 10.1055/s-0039-1678679 [doi] PST - ppublish SO - J Knee Surg. 2020 May;33(5):513-524. doi: 10.1055/s-0039-1678679. Epub 2019 Mar 5.