TY - JOUR
T1 - Trends in Polyethylene Design and Manufacturing Characteristics for Total Knee Arthroplasty
T2 - An Analysis From the American Joint Replacement Registry
AU - Kendall, Jamil
AU - Pelt, Christopher E.
AU - Yep, Patrick
AU - Mullen, Kyle
AU - Kagan, Ryland
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/4
Y1 - 2022/4
N2 - Background: Advances in polyethylene bearing characteristics have led to various options for total knee arthroplasty. We examine trends in use of polyethylene in the United States. Methods: An analysis of American Joint Replacement Registry data from 2012 to 2019 for primary total knee arthroplasty procedures was conducted. Design and manufacturing characteristics were obtained and validated in the American Joint Replacement Registry dataset. Polyethylene bearing design and manufacturing use characteristics were compared by year, gender, age group, and geographic region of the procedure. Descriptive analysis was performed. Results: We identified 993,292 cases over the study period. In total, 791,233 (80%) cases had complete device data available and were included in analysis. In addition, 366,280 (49.4%) cases utilized minimally stabilized bearings compared to 374,809 (50.6%) for posterior-stabilized bearings. Posterior-stabilized use was stable over the study period and highest in the Northeast (64.5%; P < .0001). Cruciate-retaining use decreased from 29.7% to 20.2% and anterior-stabilized use increased from 17.4% to 25.2%. Conventional polyethylene use decreased from 42.8% to 21.9%, and was highest in the 81+ age group (37.8%; P < .0001) and Northeast (43.0%; P < .0001). Highly cross-linked polyethylene (HXLPE) with antioxidant use increased from 9.08% to 31.8%, while HXLPE without antioxidant use remained constant. Conclusion: There was an increase in use of anterior-stabilized and pivot bearings and an increase in use of HXLPE with antioxidant. Additionally, there were noted age group and regional differences in the use of various bearings. Further study should evaluate if these changing utilization trends are related to clinical outcomes, or due to regional training, preferences, or manufacturer pressures. Level of evidence: Level III, retrospective.
AB - Background: Advances in polyethylene bearing characteristics have led to various options for total knee arthroplasty. We examine trends in use of polyethylene in the United States. Methods: An analysis of American Joint Replacement Registry data from 2012 to 2019 for primary total knee arthroplasty procedures was conducted. Design and manufacturing characteristics were obtained and validated in the American Joint Replacement Registry dataset. Polyethylene bearing design and manufacturing use characteristics were compared by year, gender, age group, and geographic region of the procedure. Descriptive analysis was performed. Results: We identified 993,292 cases over the study period. In total, 791,233 (80%) cases had complete device data available and were included in analysis. In addition, 366,280 (49.4%) cases utilized minimally stabilized bearings compared to 374,809 (50.6%) for posterior-stabilized bearings. Posterior-stabilized use was stable over the study period and highest in the Northeast (64.5%; P < .0001). Cruciate-retaining use decreased from 29.7% to 20.2% and anterior-stabilized use increased from 17.4% to 25.2%. Conventional polyethylene use decreased from 42.8% to 21.9%, and was highest in the 81+ age group (37.8%; P < .0001) and Northeast (43.0%; P < .0001). Highly cross-linked polyethylene (HXLPE) with antioxidant use increased from 9.08% to 31.8%, while HXLPE without antioxidant use remained constant. Conclusion: There was an increase in use of anterior-stabilized and pivot bearings and an increase in use of HXLPE with antioxidant. Additionally, there were noted age group and regional differences in the use of various bearings. Further study should evaluate if these changing utilization trends are related to clinical outcomes, or due to regional training, preferences, or manufacturer pressures. Level of evidence: Level III, retrospective.
KW - AJRR
KW - American Joint Replacement Registry
KW - database
KW - practice trends
KW - registry
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U2 - 10.1016/j.arth.2021.11.012
DO - 10.1016/j.arth.2021.11.012
M3 - Article
C2 - 34826567
AN - SCOPUS:85122931148
SN - 0883-5403
VL - 37
SP - 659
EP - 667
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 4
ER -