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Article

Titanium-Nitride Coating Does Not Result in a Better Clinical Outcome Compared to Conventional Cobalt-Chromium Total Knee Arthroplasty after a Long-Term Follow-Up: A Propensity Score Matching Analysis

1
Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria
2
Department of Orthopaedic Surgery, Landeskrankenhaus Radkersburg, 8490 Radkersburg, Austria
*
Author to whom correspondence should be addressed.
Coatings 2020, 10(5), 442; https://doi.org/10.3390/coatings10050442
Received: 24 March 2020 / Revised: 28 April 2020 / Accepted: 28 April 2020 / Published: 30 April 2020
(This article belongs to the Special Issue Recent Advanced in Implant Film Coating)
Background: The impact of titanium nitride (TiN) coating on implant components is controversial. TiN coating is proposed as having superior biomechanical properties compared to conventional cobalt-chromium (CoCr) alloy. This study compared long-term clinical data as well as meteoro-sensitivity in patients who underwent total knee arthroplasty (TKA), with either CoCr alloy or TiN coating. Methods: In this retrospective observational study, the clinically approved cemented “low contact stress” (LCS) TKA with conventional CoCr coating, was compared to un-cemented TiN-coated “advanced coated system” (ACS) TKA. Propensity score matching identified comparable patients based on their characteristics in a one-to-one ratio using the nearest-neighbor method. The final cohort comprised 260 knees in each cohort, with a mean follow-up of 10.1 ± 1.0 years for ACS patients and 14.9 ± 3.0 years for the LCS group. Physical examinations, meteoro-sensitivity, and knee scoring were assessed. Results: The clinical and functional Knee Society Score (KSS) (82.6 vs. 70.8; p < 0.001 and 61.9 vs. 71.1; p = 0.011), the postoperative Visual Analogue Scale (VAS) (2.9 vs. 1.4; p = 0.002), and the postoperative Tegner Score (2.6 vs. 2.2; p = 0.001) showed significant intergroup differences. The postoperative Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) was similar (79.9 vs. 81.3; p = 0.453) between groups. Meteoro-sensitivity of the artificial joint was significantly more prevalent in the ACS patient cohort (56% vs. 23%; p < 0.001). Conclusion: This study suggests that TiN coating does not provide improved clinical outcomes in this patient cohort after a long-term follow-up. Interestingly, sensitivity to weather changes were more correlated with un-cemented ACS implants. View Full-Text
Keywords: knee arthroplasty; functional outcome; titanium-nitride; meteoro-sensitivity knee arthroplasty; functional outcome; titanium-nitride; meteoro-sensitivity
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MDPI and ACS Style

Hauer, G.; Leitner, L.; Ackerl, M.C.; Klim, S.; Vielgut, I.; Ehall, R.; Glehr, M.; Leithner, A.; Sadoghi, P. Titanium-Nitride Coating Does Not Result in a Better Clinical Outcome Compared to Conventional Cobalt-Chromium Total Knee Arthroplasty after a Long-Term Follow-Up: A Propensity Score Matching Analysis. Coatings 2020, 10, 442. https://doi.org/10.3390/coatings10050442

AMA Style

Hauer G, Leitner L, Ackerl MC, Klim S, Vielgut I, Ehall R, Glehr M, Leithner A, Sadoghi P. Titanium-Nitride Coating Does Not Result in a Better Clinical Outcome Compared to Conventional Cobalt-Chromium Total Knee Arthroplasty after a Long-Term Follow-Up: A Propensity Score Matching Analysis. Coatings. 2020; 10(5):442. https://doi.org/10.3390/coatings10050442

Chicago/Turabian Style

Hauer, Georg, Lukas Leitner, Marc C. Ackerl, Sebastian Klim, Ines Vielgut, Reinhard Ehall, Mathias Glehr, Andreas Leithner, and Patrick Sadoghi. 2020. "Titanium-Nitride Coating Does Not Result in a Better Clinical Outcome Compared to Conventional Cobalt-Chromium Total Knee Arthroplasty after a Long-Term Follow-Up: A Propensity Score Matching Analysis" Coatings 10, no. 5: 442. https://doi.org/10.3390/coatings10050442

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