Mid-Term Outcome of Medial Pivot System for Primary Total Knee Arthroplasty

Presenting Author - JIGAR CHHAPAN
The Medial Pivot fixed-bearing prosthesis was developed specifically to enhance stability and reduce polyethylene wear by creating a near constant femoral component radius to reduce contact stresses and more normal knee kinematics. Purpose of our study is to compare the clinical and radiological midterm results in medial-pivot TKA (AdvanceTM, Wright Medical) with standard posterior stabilised (PS) TKA (PFC® sigma PS fixed bearing, Depuy). 182 patients (257 knees) of medial pivot TKA were compared with age matched 182 patients (293 knees) of PS TKA operated from October 2012 to September 2014 at our institute. At midterm, 3–5 years after surgery, Knee Society Scores (KSS), Knee Society Functional Scores (KSFS), range of motion (ROM) and WOMAC activity score were assessed and reported in this study. Midterm clinical results, including ROM and KSS, were comparable with both groups. KSFS and WOMAC activity score were equally good between the two groups. The results in this study revealed equally good clinical results with these types of implants at midterm follow-up, and complaint of anterior knee pain and crepitation observed with PS TKA was not observed significantly with medial pivot implant. Survival of the implant is 99.2% at final follow-up. We concluded that medial pivot knee will work as good as posterior stabilized fixed bearing knee in view of clinical outcome and survivalship at final follow up of 3-5 years with added advantage in patellar related complication and bone conservation by not removing central femoral bone which has to be removed in PS knee.