{
  "abstract": "Aims: To compare 15-year patient-reported outcomes measure (PROMs), pain characteristics, implant survivorship, and radiological findings between two total knee arthroplasty (TKA) systems to determine whether modern implant design influenced outcomes. Methods: A minimum 15-year follow-up of a randomised controlled trial was undertaken of patients undergoing primary TKA with either the Kinemax or Triathlon implant. We compared 15-year survivorship, mortality, patient-reported outcome measures (PROMs: Oxford Knee Score (OKS), Forgotten Joint Score (FJS), EuroQol five-dimension questionnaire (EQ-5D), and EQ visual analogue scale (VAS)), pain and location, and radiological assessments between groups. Results: There were nine revisions during the follow-up period (six aseptic and three septic), and there was no difference between the groups (p = 0.721, log-rank). A total of 108 deaths occurred, corresponding to 50.7% (95% CI 44.1 to 57.3) patient mortality at 15 years, with no difference between groups (p = 0.603, log-rank). Overall, 61 patients completed functional assessment at 15 years (mean age 80 years (SD 8.5); 41 female (67%)). There were no statistical (p ≥ 0.170) or clinically meaningful differences between groups in OKS, FJS, EQ-5D, EQ VAS, or satisfaction. Longitudinal analysis demonstrated no between-group differences in postoperative OKS or EQ-5D. However, both declined significantly over the study period (p < 0.001), but remained clinically meaningfully better than those observed preoperatively. Pain VAS scores were comparable, although anterior knee pain was more frequent in the Kinemax group (OR 3.2, p = 0.037). Radiological assessment showed no loosening. Tibial zone 1 radiolucent lines (OR 12.1, 95% CI 2.6 to 57.6, p < 0.001) and severe patellofemoral osteoarthritis (OR 5.1, 95% CI 1.4 to 18.4, p = 0.010) were more prevalent in the Kinemax group. Conclusion: Both implants were associated with comparable PROMs, and despite deterioration with increasing follow-up, they remained superior to preoperative scores. The Kinemax group demonstrated higher rates of anterior knee pain, though this difference did not result in clinically meaningful outcome disparities. Cite this article: Bone Jt Open 2026;7(10):1312–1321.",
  "abstract_shown": true,
  "affiliations": [
    "Edinburgh Orthopaedics , Royal Infirmary of Edinburgh , Edinburgh ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nick D. Clement"
    },
    {
      "affs": [
        0
      ],
      "name": "Thomas R. Williamson"
    },
    {
      "affs": [
        0
      ],
      "name": "Gillian L. Leitch"
    },
    {
      "affs": [
        0
      ],
      "name": "Chloe E. H. Scott"
    },
    {
      "affs": [
        0
      ],
      "name": "Paul Gaston"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3mny1ag7qg0dn.bib",
  "cited_by": 0,
  "doi": "10.1302/2633-1462.710.bjo-2026-0115.r1",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661153/?tool=EBI",
  "id": "3mny1ag7qg0dn",
  "issns": [
    "2633-1462"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13661153",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RD701-811"
    ],
    [
      "openalex",
      "2746|Total Knee Arthroplasty Outcomes"
    ]
  ],
  "openalex": "W7221586323",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661153/pdf/?tool=EBI",
  "pmcid": "PMC13661153",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "The British Editorial Society of Bone & Joint Surgery",
  "ris": "https://research.draconitic.com/paper/3mny1ag7qg0dn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:35Z",
      "native_id": "PMC:PMC13661153",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13661153"
    },
    {
      "first_seen": "2026-10-31T14:22:32Z",
      "native_id": "023d4582b82445a58fb335d7a7c6d157",
      "source": "doaj",
      "url": "https://doi.org/10.1302/2633-1462.710.bjo-2026-0115.r1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Total Knee Arthroplasty Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "A 15-year evaluation of two total knee arthroplasty designs : similar patient-reported outcomes and survivorship but divergent patellofemoral and radiological outcomes",
  "title_text": "A 15-year evaluation of two total knee arthroplasty designs : similar patient-reported outcomes and survivorship but divergent patellofemoral and radiological outcomes",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:22:32Z",
  "url": "https://research.draconitic.com/paper/3mny1ag7qg0dn",
  "venue": "Bone & joint open",
  "versions": []
}