Trial Outcomes & Findings for X-3 Polyethylene Survival Outcomes Study (NCT NCT00493792)

NCT ID: NCT00493792

Last Updated: 2024-11-06

Results Overview

The survival of prostheses free of revision 10 years post operation.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

518 participants

Primary outcome timeframe

From operation to 10 years post-operative

Results posted on

2024-11-06

Participant Flow

Patients were recruited at the following sites: Mayo Clinic in Rochester, MN, Mayo Clinic in Florida, and Mayo Clinic in Arizona. Patients, who met study criteria, planning to undergo a total knee replacement were offered study participation at their pre-operative visit.

Participant milestones

Participant milestones
Measure
Control
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. Stryker X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
Overall Study
STARTED
254
264
Overall Study
Year 2
245
256
Overall Study
Year 5
233
241
Overall Study
Year 7
207
211
Overall Study
COMPLETED
163
163
Overall Study
NOT COMPLETED
91
101

Reasons for withdrawal

Reasons for withdrawal
Measure
Control
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. Stryker X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
Overall Study
Death
55
50
Overall Study
Lost to Follow Up or Lack of Efficacy
36
51

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Control
n=254 Participants
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
n=264 Participants
X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. Stryker X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
Total
n=518 Participants
Total of all reporting groups
Age, Continuous
67 years
STANDARD_DEVIATION 9 • n=254 Participants
67 years
STANDARD_DEVIATION 9 • n=264 Participants
67 years
STANDARD_DEVIATION 9 • n=518 Participants
Sex: Female, Male
Female
145 Participants
n=254 Participants
155 Participants
n=264 Participants
300 Participants
n=518 Participants
Sex: Female, Male
Male
109 Participants
n=254 Participants
109 Participants
n=264 Participants
218 Participants
n=518 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Height (cm)
169 centimeters
STANDARD_DEVIATION 10 • n=254 Participants
169 centimeters
STANDARD_DEVIATION 10 • n=264 Participants
169 centimeters
STANDARD_DEVIATION 10 • n=518 Participants
Weight (kg)
92 kilograms
STANDARD_DEVIATION 21 • n=254 Participants
92 kilograms
STANDARD_DEVIATION 21 • n=264 Participants
92 kilograms
STANDARD_DEVIATION 21 • n=518 Participants
BMI, kg/m^2
32 Kilogram-Square Meter (kg/m^2)
STANDARD_DEVIATION 7 • n=254 Participants
32 Kilogram-Square Meter (kg/m^2)
STANDARD_DEVIATION 6 • n=264 Participants
32 Kilogram-Square Meter (kg/m^2)
STANDARD_DEVIATION 7 • n=518 Participants
Previous knee surgery, n (%)
Yes, previous knee surgery
91 Participants
n=254 Participants
82 Participants
n=264 Participants
173 Participants
n=518 Participants
Previous knee surgery, n (%)
No, previous knee surgery
157 Participants
n=254 Participants
179 Participants
n=264 Participants
336 Participants
n=518 Participants
Previous knee surgery, n (%)
Unknown
6 Participants
n=254 Participants
3 Participants
n=264 Participants
9 Participants
n=518 Participants

PRIMARY outcome

Timeframe: From operation to 10 years post-operative

Population: Patients were recruited from three academic, tertiary-care referral centers within one healthcare network. Patients approached for enrollment received a primary unilateral total knee arthroplasty (TKA) for a diagnosis of osteoarthritis (OA), avascular necrosis (AVN) or posttraumatic arthritis.

The survival of prostheses free of revision 10 years post operation.

Outcome measures

Outcome measures
Measure
Control
n=254 Participants
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
n=264 Participants
Stryker Orthopaedics X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
Prosthesis Survivorship Free of Revision
96 percentage of prosthesis survivorship
Interval 93.0 to 98.0
97 percentage of prosthesis survivorship
Interval 94.0 to 99.0

SECONDARY outcome

Timeframe: From operation to 10 years post-operative

Population: Patients were recruited from three academic, tertiary-care referral centers within one healthcare network. Patients approached for enrollment received a primary unilateral total knee arthroplasty (TKA) for a diagnosis of osteoarthritis (OA), avascular necrosis (AVN) or posttraumatic arthritis.

The survival of prostheses free of reoperation 10 years post operation.

Outcome measures

Outcome measures
Measure
Control
n=254 Participants
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
n=264 Participants
Stryker Orthopaedics X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
Prosthesis Survivorship Free of Reoperation
92 percentage of prosthesis survivorship
Interval 89.0 to 96.0
96 percentage of prosthesis survivorship
Interval 93.0 to 99.0

SECONDARY outcome

Timeframe: From operation to 10 years post-operative

Population: Patients were recruited from three academic, tertiary-care referral centers within one healthcare network. Patients approached for enrollment received a primary unilateral total knee arthroplasty (TKA) for a diagnosis of osteoarthritis (OA), avascular necrosis (AVN) or posttraumatic arthritis.

The survival of prostheses free of related complications (non-operative) 10 years post operation.

Outcome measures

Outcome measures
Measure
Control
n=254 Participants
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
n=264 Participants
Stryker Orthopaedics X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
Prosthesis Survivorship Free of Complications
84.9 percentage of prosthesis survivorship
Interval 80.2 to 89.5
88.8 percentage of prosthesis survivorship
Interval 84.5 to 92.8

SECONDARY outcome

Timeframe: Pre-operative (baseline) and 10-years post-operative

Population: Patients who completed the Knee Society Score at baseline and patients who completed the Knee Society Score at 10-years post-operation. Data was not collected nor analyzed for 90 patients in the control arm, and 93 patients in the treatment arm at the 10 year follow-up.

The KSS evaluates pain, stability and range of motion. The scale ranges between scores of 0-100. The maximum score of 100 points is reached when there is no pain, with good alignment of the knee in extension, and at least 125° of range of motion, without any anteroposterior or mediolateral instability. Deductions are made for flexion contracture, loss of extension and poor alignment. Higher scores indicate better knee conditions, while lower scores indicate worse knee conditions.

Outcome measures

Outcome measures
Measure
Control
n=123 Participants
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
n=121 Participants
Stryker Orthopaedics X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
Knee Society Score (KSS)
Baseline Score
39.9 score on a scale
Standard Deviation 14.19
39.0 score on a scale
Standard Deviation 12.56
Knee Society Score (KSS)
10-Year Follow-Up Score
77.6 score on a scale
Standard Deviation 8.60
76.5 score on a scale
Standard Deviation 6.32

SECONDARY outcome

Timeframe: Pre-operative (baseline) and 10-years post-operative

Population: Patients who completed the Knee Society Function Score at baseline and patients who completed the Knee Society Function Score at 10-years post-operation. Data was not collected nor analyzed for 62 patients in the control arm, and 47 patients in the treatment arm at the 10 year follow-up.

The Function KSS evaluates the walking distance and the act of climbing and descending stairs. The scale ranges between 0-100. The maximum score of 100 points is attributed to the individual capable of walking unlimited distances without walking aids, and of climbing and descending stairs normally. Deductions are made for the use of canes, crutches or walking frame. Higher scores indicate better knee conditions, while lower scores indicate worse knee conditions.

Outcome measures

Outcome measures
Measure
Control
n=156 Participants
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
n=159 Participants
Stryker Orthopaedics X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
Knee Society Score (KSS): Function
Baseline Score
58.3 score on a scale
Standard Deviation 17.38
59.1 score on a scale
Standard Deviation 15.48
Knee Society Score (KSS): Function
10-Year Follow-Up Score
70.2 score on a scale
Standard Deviation 26.25
70.3 score on a scale
Standard Deviation 26.16

SECONDARY outcome

Timeframe: Pre-operative (baseline) and 10-years post-operative

Population: Patients who completed the SF-12 Mental Health Score at baseline and patients who completed the SF-12 Mental Health Score at 10-years post-operation. Data was not collected nor analyzed for 187 patients in the control arm, and 193 patients in the treatment arm at the 10 year follow-up.

The SF-12 questionnaire uses questions selected from the longer SF-36 Health Survey to measure patient wellness and quality of life. The scoring algorithm is calibrated so that an average healthy person would have a t-score of 50 points with a standard deviation of 10. Higher scores indicate better mental health.

Outcome measures

Outcome measures
Measure
Control
n=228 Participants
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
n=233 Participants
Stryker Orthopaedics X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
12-Item Short Form Health Survey (SF-12): Mental Health Score
Baseline Score
56 score on a scale
Standard Deviation 9.64
56.2 score on a scale
Standard Deviation 8.89
12-Item Short Form Health Survey (SF-12): Mental Health Score
10-Year Follow-Up Score
56.8 score on a scale
Standard Deviation 6
56.3 score on a scale
Standard Deviation 7.65

SECONDARY outcome

Timeframe: Pre-operative (baseline) and 10-years post-operative

Population: Patients who completed the SF-12 Physical Health Score at baseline and patients who completed the SF-12 Physical Health Score at 10-years post-operation. Data was not collected nor analyzed for 187 patients in the control arm, and 193 patients in the treatment arm at the 10 year follow-up.

The SF-12 questionnaire uses questions selected from the longer SF-36 Health Survey to measure patient wellness and quality of life. The scoring algorithm is calibrated so that an average healthy person would have a t-score of 50 points with a standard deviation of 10. Higher scores indicate better physical health.

Outcome measures

Outcome measures
Measure
Control
n=228 Participants
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
n=233 Participants
Stryker Orthopaedics X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
12-Item Short Form Health Survey (SF-12): Physical Health Score
Baseline Score
32.5 score on a scale
Standard Deviation 8.34
33.2 score on a scale
Standard Deviation 8.59
12-Item Short Form Health Survey (SF-12): Physical Health Score
10-Year Follow-Up Score
41.9 score on a scale
Standard Deviation 11.28
44.4 score on a scale
Standard Deviation 10.37

SECONDARY outcome

Timeframe: 10 years post-operative

Population: Patients who completed 10-year post-operation radiographs of the study-related prosthetic joint.

Radiographic review for success and or failure of the TKA prostheses at 10 years post-operation. A migrating or shifting prosthesis with or without the disappearance of radiolucent lines is considered a failure.

Outcome measures

Outcome measures
Measure
Control
n=40 Participants
Stryker Orthopaedics N2Vac Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. N2Vac Polyethylene: Ultra-high-molecular-weight polyethylene (UHMWPE).
Treatment
n=23 Participants
Stryker Orthopaedics X3 Polyethylene when used with a Triathlon Posterior Stabilized total knee system. This is a fixed- bearing knee intended for use in patients undergoing cemented total knee arthroplasty. X3 Crosslink Polyethylene: Highly cross-linked polyethylene (HXLPE).
Comparison of Radiographic Success/Failure Between Groups
Loosening and/or Osteolysis
0 Participants
0 Participants
Comparison of Radiographic Success/Failure Between Groups
Tibial component bone-cement interface: Non-progressive radiolucent lines
7 Participants
2 Participants
Comparison of Radiographic Success/Failure Between Groups
Femoral component bone-prosthesis interface: Radiolucent lines
3 Participants
0 Participants

Adverse Events

Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 55 deaths

Treatment

Serious events: 0 serious events
Other events: 0 other events
Deaths: 50 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Emilee Andersen, M.A., Clinical Research Coordinator

Mayo Clinic, Rochester, MN

Phone: 507-266-9807

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place