Authors: Mikko Peltola Antti Malmivaara Mika Paavola
Publish Date: 2011/12/09
Volume: 470, Issue: 6, Pages: 1711-1717
Abstract
We studied mandatory registry data from all centers in Finland n = 69 that performed TKAs for primary osteoarthritis between 1998 and 2004 Of the total of 23707 patients 28760 TKAs 22551 patients 27105 TKAs had a followup of 5 years we excluded longer followup from the analysis as subsequent revisions might result from wear rather than early technical failures We used proportional hazards modeling for calculating the hazard ratios for the first 15 operations and subsequent increments of numbers of operations while adjusting for potentially confounding variablesFor the first 15 operations with a new endoprosthesis the risk was elevated hazard ratio 148 95 confidence interval 114–191 Absolute risk increase of early revision for the first 15 patients was 17 95 confidence interval 07–27 The risk was not increased as the numbers of TKAs incrementally performed increasedOur data show an increased risk of early revision surgery for the first patients obtaining a knee endoprosthesis model previously unused in the hospital Patients should be informed if there is a plan to introduce a new model of endoprosthesis in the hospital and offered the possibility to choose a conventional endoprosthesis instead Although introducing potentially better endoprostheses is important there is a need for managed introduction of new technologyEach author certifies that he or she or a member of their immediate family has no commercial associations eg consultancies stock ownership equity interest patent/licensing arrangements etc that might pose a conflict of interest in connection with the submitted articleClinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment drug or device Readers are encouraged to always seek additional information including FDAapproval status of any drug or device prior to clinical useEach author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research and that informed consent for participation in the study was obtained
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