The Journal of Arthroplasty, Volume 36, Issue 1, 140 - 147.e2

Titanium Niobium Nitride Mobile-Bearing Unicompartmental Knee Arthroplasty Results in Good to Excellent Clinical and Radiographic Outcomes in Metal Allergy Patients With Medial Knee Osteoarthritis

D’Ambrosi, Riccardo et al.


The main purpose of the present study was to analyze the clinical and radiological outcomes of patients with positive skin patch tests who underwent medial mobile-bearing titanium niobium nitride unicompartmental knee arthroplasty (UKA) during a mid-term follow-up.


Thirty-seven patients with positive skin patch tests were included in this prospective study. The clinical evaluation consisted of Oxford Knee Score and Knee Society Score (KSS) reports. Each patient was clinically evaluated the day before surgery (T 0) as well as at T 1 (11.9 ± 1.3 months) and during the final follow-up T 2 (67.2 ± 19.1 months). The positioning of the UKA was evaluated during the final follow-up using standardized radiographs (T 2: 67.2 ± 19.1 months).


Oxford and KSS ranged from a respective mean preoperative value of 23.0 ± 2.7 and 51.5 ± 5.0 to 42.1 ± 1.7 and 87.6 ± 2.2, respectively, at T 1 ( P < .001) and to the final values of 45.0 ± 1.9 and 91.9 ± 3.4, respectively, at T 2 ( P < .001 both vs T 1 and T 2). At T 2, the mean femoral angle was 7.0° ± 4.5°, mean tibial angle was 3.0° ± 2.1°, and mean tibial slope was 5.1° ± 3.2°. A significant difference was found between KSS and Oxford with ANOVA for repeated measures over time ( P < .001). The Oxford and KSS scores showed significant improvements during each follow-up. No complications were found, and not a single patient required a revision surgery during the follow-up period.


The hypoallergenic titanium niobium nitride mobile-bearing UKA showed comparable results to standard CoCr UKA regardless of the gender, age, BMI, and implant size of metal allergy patients with medial knee osteoarthritis. Careful patient selection processes and accurate medical histories played key roles in the choice of hypersensitivity-friendly implants.

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