Lower prosthesis-specific 10-year revision rate with crosslinked than with non-crosslinked polyethylene in primary total knee arthroplasty

Figures & data

Figure 1. Relative proportions of primary total knee replacements according to type of polyethylene bearing surface (all diagnoses).

Figure 2. Cumulative percentage revision of primary total knee replacements according to type of polyethylene bearing surface (with OA as primary diagnosis).

Figure 3. Cumulative percentage revision of primary total knee replacements according to type of polyethylene bearing surface (revision for loosening/lysis, with OA as primary diagnosis). Non crosslinked vs crosslinked (entire period): HR = 1.80 (1.61–2.02), p < 0.001 (HR adjusted for age and sex).

Table 1. Revision diagnosis of primary total knee replacement according to type of polyethylene bearing surface (with OA as primary diagnosis)

Revision diagnosis	Number	Crosslinked % Revision	% Primary	Number	Non-crosslinked % Revision	% Primary
Loosening/Lysis	341	23.5	0.4	3,545	30.0	1.2
Infection	461	31.8	0.5	2,463	20.8	0.8
Patellofemoral pain	140	9.7	0.2	1,467	12.4	0.5
Pain	117	8.1	0.1	1,119	9.5	0.4
Instability	86	5.9	0.1	720	6.1	0.2
Arthrofibrosis	56	3.9	0.1	425	3.6	0.1
Patellar erosion	51	3.5	0.1	368	3.1	0.1
Fracture	37	2.6	0.0	292	2.5	0.1
Malalignment	34	2.3	0.0	266	2.3	0.1
Metal-related pathology	3	0.2	0.0	236	2.0	0.1
Tibial wear	16	1.1	0.0	198	1.7	0.1
Other	108	7.4	0.1	723	6.1	0.2
Total number of
revisions	1,450	100	1.7	11,822	100	3.9
primaries	83,890			302,214

Figure 4. Cumulative percentage revision of primary total knee replacements in patients aged < 65 years, according to type of polyethylene bearing surface (with OA as primary diagnosis).

Table 2. Cumulative percentage revision (95% confidence intervals) of primary total knee replacements according to type of polyethylene bearing surface and age, for specific prostheses (with OA as primary diagnosis)

Model	Revised	Total	Cumulative percentage revision
Polyethylene/ Age	n	n	1 year	3 years	5 years	7 years	10 years	13 years
Natural Knee II/Natural Knee II
crosslinked	93	3,312	1.0 (0.7–1.4)	2.1 (1.6–2.7)	2.8 (2.2–3.5)	3.1 (2.5–3.8)	3.8 (3.0–4.7)
non-crosslinked	190	2,860	0.8 (0.5–1.2)	2.0 (1.5–2.5)	3.0 (2.4–3.7)	4.3 (3.6–5.2)	7.4 (6.3–8.5)	9.9 (8.5–11.6)
Triathlon CR/Triathlon
crosslinked	369	25,839	0.7 (0.6–0.9)	2.0 (1.8–2.2)	2.7 (2.3–3.1)
non-crosslinked	182	8,060	0.8 (0.6–1.0)	1.9 (1.6–2.3)	2.6 (2.2–3.0)	3.0 (2.6–3.5)
Triathlon PS/Triathlon
crosslinked	72	3,149	1.8 (1.4–2.4)	2.8 (2.2–3.5)	3.2 (2.5–4.1)
non-crosslinked	126	3,182	1.8 (1.4–2.3)	3.7 (3.0–4.4)	4.6 (3.8–5.5)	5.2 (4.3–6.3)
Nexgen CR/Nexgen
crosslinked	437	27,193	0.7 (0.6–0.8)	1.6 (1.4–1.8)	2.0 (1.8–2.2)	2.2 (2.0–2.5)	2.8 (2.5–3.2)
age < 65	216	9,000	1.0 (0.8–1.3)	2.4 (2.1–2.8)	3.1 (2.7–3.6)	3.4 (2.9–3.9)	4.3 (3.6–5.1)
age ≥ 65	221	18,193	0.6 (0.5–0.7)	1.2 (1.0–1.4)	1.5 (1.3–1.7)	1.7 (1.4–1.9)	2.1 (1.7–2.5)
non-crosslinked	224	8,735	0.5 (0.3–0.6)	1.6 (1.3–1.9)	2.1 (1.8–2.4)	2.5 (2.1–2.9)	3.2 (2.7–3.7)	5.2 (4.2–6.5)
age < 65	99	1,968	0.6 (0.4–1.1)	2.4 (1.7–3.2)	3.7 (2.9–4.7)	4.6 (3.6–5.7)	5.8 (4.6–7.1)	10 (7.7–14)
age ≥ 65	125	6,767	0.4 (0.3–0.6)	1.4 (1.1–1.7)	1.6 (1.3–2.0)	1.8 (1.5–2.2)	2.4 (2.0–2.9)	3.3 (2.4–4.5)
total	661	35,928	0.7 (0.6–0.8)	1.6 (1.5–1.7)	2.0 (1.9–2.2)	2.3 (2.1–2.5)	2.9 (2.7–3.2)	4.9 (4.0–6.1)
Nexgen PS/Nexgen
crosslinked	184	8,364	1.0 (0.8–1.2)	2.5 (2.1–2.9)	3.2 (2.7–3.8)	3.9 (3.2–4.7)
non-crosslinked	681	1,9281	0.9 (0.8–1.0)	2.3 (2.1–2.6)	3.3 (3.0–3.5)	4.1 (3.8–4.5)	5.2 (4.8–5.7)	6.1 (5.4–7.0)
Scorpio NRG CR/Series 7000
crosslinked	35	2,454	0.7 (0.4–1.1)	1.6 (1.1–2.3)	2.0 (1.4–2.8)
non-crosslinked	13	406	0.2 (0.0–1.7)	1.2 (0.5–3.0)	2.1 (1.0–4.2)
Scorpio NRG PS/Series 7000
crosslinked	92	2,910	0.9 (0.6–1.3)	3.6 (2.9–4.5)	4.5 (3.6–5.6)
non-crosslinked	15	504	0.6 (0.2–1.8)	1.6 (0.8–3.2)	3.1 (1.9–5.1)

Figure 5. Cumulative percentage revision of minimally stabilized Nexgen primary total knee replacements according to type of polyethylene bearing surface and age (with OA as primary diagnosis).