Evidence map›Paper›PMID 39584822›Full record

ArticleActa orthopaedica2024

Safety notices and registry outlier data measure different aspects of safety and performance of total knee implants: a comparative study of safety notices and register outliers.

Lotje A Hoogervorst, Yijun Ren, Tom Melvin, Ashley A Stratton-Powell, Anne Lübbeke, Robert E Geertsma, Alan G Fraser, Rob G H H Nelissen, Enrico G Caiani, Perla J Marang-van de Mheen

Abstract readComparative Study
In one paragraph

Article in Acta orthopaedica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lotje A HoogervorstDepartment of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands. l.a.hoogervorst@lumc.nl.ORCID 0000-0001-5343-6965
Yijun RenDepartment of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Milan, Italy.ORCID 0000-0001-5361-2447
Tom MelvinSchool of Medicine, Trinity College Dublin, Dublin, Ireland.
Ashley A Stratton-PowellSchool of Medicine, Trinity College Dublin, Dublin, Ireland.
Anne LübbekeDivision of Orthopaedic Surgery and Traumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-6905-6120
Robert E GeertsmaCentre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.ORCID 0000-0003-0979-9077
Alan G FraserDepartment of Cardiology, University Hospital of Wales, Heath Park Way, Cardiff, UK.
Rob G H H NelissenDepartment of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands.ORCID 0000-0003-1228-4162
Enrico G CaianiDepartment of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Milan; Istituto Auxologico Italiano IRCCS, Milan, Italy.
Perla J Marang-van de MheenDepartment of Orthopaedics, Leiden University Medical Center, Leiden; Safety & Security Science and Centre for Safety in Healthcare, Delft University of Technology, Delft, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeSafety notices for medical devices such as total knee arthroplasty (TKA) implants may indicate problems in their design or performance that require corrective action to prevent patient harm. Safety notices are often published on national Ministries of Health or regulatory agencies websites. It is unknown whether problems triggering safety notices identify the same implants as those identified by registries as "outlier." We aimed to assess the extent to which safety notices and outlier identification in registries signal the same or different TKA implants.

methodsThe CORE-MD tool, an automated web scraper tool, was used to collect safety notices related to TKA implants on 13 national Ministries of Health websites and regulatory agencies. Safety notices were defined according to the Medical Device Regulation (MDR) as "a communication sent by a manufacturer to users or customers in relation to a field safety corrective action." Identified TKA outliers, defined as having a significantly higher revision risk than other comparable TKA implants, were extracted from registry reports.

results787 safety notices for 38 TKA implants and 35 TKA outliers were identified, together identifying 47 unique TKA implants. 26 (55%) TKA implants had safety notices and were also outliers, 12 (26%) TKA implants had only safety notices, and 9 (19%) were outliers only. TKA implants with safety notices only had similar types of problems to TKA outliers with safety notices, with "Manufacturing/Packaging/Shipping" problems being most frequent (44%). Cumulative revision risks (1/5/10 years) were lower for TKA implants with safety notices only than for TKA outliers with safety notices.

conclusion55% of the TKA with a safety notice were identified as outliers in the registry, whereas around 25% of TKA outliers are not the subject of publicly released safety notices, with safety notices pointing to TKA implants not identified by registries as potentially having a higher risk of failure. This suggests that safety notices and registry outlier data measure different aspects of safety and performance.

Indexed as

Arthroplasty, Replacement, KneeEquipment SafetyKnee ProsthesisPatient SafetyProduct Surveillance, PostmarketingProsthesis FailureRegistriesHumansMedical Device RecallsProsthesis DesignReoperation

Identifiers

PMID39584822
PMCPMC11587162

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.