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Home/Large Joints and Extremities/MicroPort: Satisfaction (95%) and Survivorship (98.8%)!
Large Joints and Extremities

MicroPort: Satisfaction (95%) and Survivorship (98.8%)!

April 3, 2017 2 min read Premium comments

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MicroPort: Satisfaction (95%) and Survivorship (98.8%)!
EVOLUTION Medial-Pivot Knee System / Courtesy of MicroPort Orthopedics, Inc.
Secondary

There are exciting things happening in Arlington, Tennessee, these days. A certain medical device company—MicroPort Orthopedics, Inc.—is celebrating recently published results indicating very high patient satisfaction rates (95%), as well as survivorship (98.8%), with its Medial-Pivot Knee System. The research, published in The Knee, is entitled, “A Long Term Clinical Outcome of the Medial Pivot Knee Arthroplasty System.” It was written by George A. Macheras, M.D., Ph.D., et al. from the “KAT” General Hospital, Athens, Greece.

David Backstein, M.D., M.Ed., F.R.C.S.C., is head of Orthopaedic Surgery at Mount Sinai Hospital in Toronto, Ontario. Dr. Backstein commented to OTW, “It has been reported that approximately 20% of patients are not satisfied with the outcome of their total knee replacement as a result of residual pain and functional issues often attributed to implant design. MicroPort’s Medial-Pivot Knee System is uniquely designed to restore stability and normal knee kinematics to deliver reproducible outcomes that can improve function and drive patient satisfaction.”

Dr. Backstein added, “I am in my third year of using the Evolution Medial-Pivot Knee System and this publication validates the results that I have seen in my practice. In my experience, the functional outcomes for patients treated with this system have certainly been superior to the systems I’ve used in the past and patients have fewer complaints. When I see them at six or eight weeks follow-up, they’re at a different stage of recovery than I was seeing previously with traditional implant designs. I’ve been exceptionally happy with the results and feel comfortable knowing I am implanting a prosthesis with 98.8% survivorship at 17 years.”

According to the February 28, 2017 news release, “In the study, 325 patients with knee osteoarthritis underwent Total Knee Arthroplasty (TKA) using the Medial-Pivot prosthesis. All patients showed a statistically significant improvement in the Knee Society clinical rating system, Western Ontario and McMaster Universities Osteoarthritis Index, and Oxford knee score. The majority of patients (94%) were able to perform age-appropriate activities with average knee flexion of 120° and 98% of patients reported relief of pain to be excellent, very good or good. Additionally, survival analysis showed a cumulative success rate of 98.8% at 17 years.”

Based on information from the company, we learned that current literature reports that around 20% of patients are not satisfied with the outcome of their total knee replacement. This dissatisfaction is often the result of residual pain and functional issues, which can often be attributed to design of the implant used in surgery. Unlike traditional total knee implant designs, the EVOLUTION Medial-Pivot Knee has a unique design that restores stability and normal knee kinematics to help maximize function and drive patient satisfaction. With a stable, pivoting medial side and a lateral side that rolls backward throughout flexion, the system is designed to feel and function like a natural knee.”

In addition, we learned that the EVOLUTION Medial-Pivot Knee system has a long clinical history supported by over 90 clinical publications highlighting a 98.8% survivorship rate and 95% patient satisfaction rate at 17 years. To be able to demonstrate both long-term patient satisfaction and long-term survivorship is incredibly compelling. In addition, several studies have demonstrated that patients with the EVOLUTION Medial-Pivot Knee have more normal quadriceps force pattern and enhanced quadriceps efficiency, which can increase patient proprioception, or awareness of the knee’s position, and ultimately create a more normal, natural feeling for the patient.

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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