{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T04:05:31Z","timestamp":1751083531724,"version":"3.41.0"},"reference-count":23,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose: \u00a0Backside wear of the polyethylene insert in total knee arthroplasty (TKA) has been described to produce clinically significant levels of polyethylene debris, which can lead to aseptic loosening and osteolysis. Monoblock design eliminates backside wear of the polyethylene and therefore could improve long-term fixation. This randomized clinical trial (RCT) using radiostereometric analysis (RSA) compares micromotion of monoblock and modular polyethylene inserts with 7 years\u2019 follow-up.Methods:\u00a065 patients (mean age 61 years) were randomized to receive either monoblock (n = 32) or modular (n = 33) uncemented trabecular metal tibial components. 35 patients (monoblock = 18, and modular = 17) completed 7 years\u2019 follow-up. The primary endpoint of the study was maximum total point motion (MTPM). Implant translation and rotation are reported as secondary endpoints.Results:\u00a0After 84 months, the modular group had a statistically significant higher mean MTPM of 1.17 (95% confidence interval [CI] 0.90\u20131.41) mm compared with the monoblock group of 0.78 (CI 0.55\u20130.88) mm (P = 0.02). However, there was no difference in continuous migration (from 12\u201384 months), which was 0.13 mm in the monoblock group and 0.16 mm in the modular group.Conclusion:\u00a0There was significantly lower early migration in the monoblock group compared with the modular group but no difference in continuous migration after 12 months, which confirms the finding of previous publications.<\/jats:p>","DOI":"10.2340\/17453674.2025.43904","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T10:32:48Z","timestamp":1751020368000},"page":"485-491","source":"Crossref","is-referenced-by-count":0,"title":["Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis"],"prefix":"10.2340","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3405-7147","authenticated-orcid":false,"given":"Mikkel Rathsach","family":"Andersen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mu\u0308jgan","family":"Yilmaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaj","family":"Winther","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Lind","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Schr\u00f8der","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6872-4174","authenticated-orcid":false,"given":"Gunnar FLIVIK","family":"Flivik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2324-6420","authenticated-orcid":false,"given":"Michael","family":"M\u00f8rk Petersen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"116581","doi-asserted-by":"crossref","unstructured":"Sharkey P F, Lichstein P M, Shen C, Tokarski A T, Parvizi J. 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Acta Orthop 2016; 87: 504-10. doi: 10.1080\/17453674.2016.1205169.","DOI":"10.1080\/17453674.2016.1205169"},{"key":"116590","doi-asserted-by":"crossref","unstructured":"Dunbar M J, Wilson D A J, Hennigar A W, Amirault J D, Gross M, Reardon G P. Fixation of a trabecular metal knee arthroplasty component: a prospective randomized study. J Bone Joint Surg Am 2009; 91: 1578-86. doi: 10.2106\/JBJS.H.00282.","DOI":"10.2106\/JBJS.H.00282"},{"key":"116591","doi-asserted-by":"crossref","unstructured":"Puijk R, Singh J, Puijk R H, Laende E K, Plevier J W M, Nolte P A, et al. Evaluation and refinement of thresholds for early migration of total knee replacements as an estimator of late aseptic loosening: an updated systematic review of RSA and survival studies. Acta Orthop 2025; 96: 1-10. doi: 10.2340\/17453674.2024.42574.","DOI":"10.2340\/17453674.2024.42574"},{"key":"116592","doi-asserted-by":"crossref","unstructured":"Puijk R, Koster L A, Pijls B G C W, Singh J, Schager M, Kaptein B L, et al. 5-year migration and inducible displacement of the uncemented LCS and ATTUNE rotating platform knee systems: a secondary report of a randomized controlled RSA trial. Acta Orthop 2025; 96: 59-65. doi: 10.2340\/17453674.2024.42744.","DOI":"10.2340\/17453674.2024.42744"},{"key":"116593","doi-asserted-by":"crossref","unstructured":"Andersen M R, Winther N, Lind T, Schr\u00f8Der H, Flivik G, Petersen M M. Monoblock versus modular polyethylene insert in uncemented total knee arthroplasty. Acta Orthop 2016; 87: 607-14. doi: 10.1080\/17453674.2016.1233654.","DOI":"10.1080\/17453674.2016.1233654"},{"key":"116594","doi-asserted-by":"crossref","unstructured":"Kaptein B L, Pijls B, Koster L, K\u00e4rrholm J, Hull M, Niesen A, et al. Guideline for RSA and CT-RSA implant migration measurements: an update of standardizations and recommendations. Acta Orthop 2024; 95: 256-67. doi: 10.2340\/17453674.2024.40709.","DOI":"10.2340\/17453674.2024.40709"},{"key":"116595","doi-asserted-by":"crossref","unstructured":"Ryd L, Albrektsson B E, Carlsson L, Dansg\u00e5rd F, Herberts P, Lindstrand A, et al. Roentgen stereophotogrammetric analysis as a predictor of mechanical loosening of knee prostheses. J Bone Joint Surg Br 1995; 77:377-83. PMID: 7744919.","DOI":"10.1302\/0301-620X.77B3.7744919"},{"key":"116596","doi-asserted-by":"crossref","unstructured":"Wojtowicz R, Henricson A, Nilsson K G, Crnalic S. Uncemented monoblock trabecular metal posterior stabilized high-flex total knee arthroplasty: similar pattern of migration to the cruciate-retaining design\u2014a prospective radiostereometric analysis (RSA) and clinical evaluation of 40 patients (49 knees) 60 years or younger with 9 years\u2019 follow-up. 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