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Abstract
Background and purpose In a previous radiostereometric (RSA) trial the uncoated, uncemented, Interax tibial components showed excessive migration within 2 years compared to HA-coated and cemented tibial components. It was predicted that this type of fixation would have a high failure rate. The purpose of this systematic review and meta-analysis was to investigate whether this RSA prediction was correct.
Materials and methods We performed a systematic review and meta-analysis to determine the revision rate for aseptic loosening of the uncoated and cemented Interax tibial components.
Results 3 studies were included, involving 349 Interax total knee arthroplasties (TKAs) for the comparison of uncoated and cemented fixation. There were 30 revisions: 27 uncoated and 3 cemented components. There was a 3-times higher revision rate for the uncoated Interax components than that for cemented Interax components (OR = 3; 95% CI: 1.4–7.2).
Interpretation This meta-analysis confirms the prediction of a previous RSA trial. The uncoated Interax components showed the highest migration and turned out to have the highest revision rate for aseptic loosening. RSA appears to enable efficient detection of an inferior design as early as 2 years postoperatively in a small group of patients.
The following authors designed the study (SM, BGP, RGN, ERV), designed the search strategy for the literature search (JWS), performed the study selection (BGP, MJN), appraised the quality of the literature (BGP, MJN), analyzed the data (BGP, SM), wrote the draft manuscript (ERV, BGP, JWS, MJN), and ensured the accuracy of the data and the analysis (SM, RGN). Critical revision of the manuscript was performed by all authors.
The authors thank the Atlantic Innovation Fund (Atlantic Canada Opportunities Agency) and the Dutch Arthritis Association (LRR 13) for providing funding for this study. The Atlantic Innovation Fund and the Dutch Arthritis Association (LRR 13) did not take part in the design and conduction of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, and approval of the manuscript.