LEGION Revision Knee System Using Oxidized Zirconium Technology Improves Short-Term Clinical Outcomes and Reduces Re-revision Rates: Insights from a Large US Claims Database
Author(s)
Chien-Cheng Chen, PhD, Leo M. Nherera, BSc, MSc, PhD;
Smith + Nephew, Fort Worth, TX, USA
Smith + Nephew, Fort Worth, TX, USA
OBJECTIVES: This research aimed to assess the hospital-related clinical outcomes for patients undergoing total knee revision procedures who utilized the LEGION◊ revision knee system with oxidized zirconium (OxZr), hereafter referred to as LEGION, to those who used other systems.
METHODS: A retrospective analysis of patients undergoing total knee revision was performed using the Premier PINC AI Healthcare Database. The earliest encounter was assigned as the index admission. Exclusions included patients under 21, those with bilateral or unknown laterality, malignant neoplasms, fractures, or periprosthetic fractures, as well as patients who expired within 2 years post-discharge or lacked a 12-month baseline and follow-up. LEGION patients were identified through keyword analysis in billing records. A 1:5 propensity score matching was performed to balance the cohorts' baseline characteristics. Hospital-related clinical outcomes were then analyzed using generalized linear models. Kaplan-Meier survival analysis and Cox proportional hazards model were also used to assess revision outcomes.
RESULTS: The study matched 2,769 LEGION patients to 13,845 using other systems. Compared to patients without LEGION implants, patients with LEGION implants had shorter lengths of stay of index admission (Ratio=0.92; p<.0001). After index admission discharge, LEGION patients had lower odds of having all-cause inpatient readmission (OR=0.81; p=.0020, and OR=0.86; p=.0125) and fewer inpatient readmissions (Ratio=0.84; p=.0086, and Ratio=0.89; p=.0434) within 6 or 12 months. LEGION patients also had lower odds of developing knee infections or inflammatory reactions during the 12-month follow-up period. In addition, LEGION patients had a higher survival probability (p=.0113) and lower hazard (HR=0.73; p=.0117) for total re-revision post-discharge.
CONCLUSIONS: Retrospective data indicated that patients with LEGION with OxZr implants experienced shorter hospital stays, fewer inpatient readmissions, and less incidence of infections or total re-revision surgery. This information enables healthcare professionals and payors to make well-informed decisions regarding these critical choices about implant systems. ◊Trademark of Smith+Nephew. All Trademarks acknowledged.
METHODS: A retrospective analysis of patients undergoing total knee revision was performed using the Premier PINC AI Healthcare Database. The earliest encounter was assigned as the index admission. Exclusions included patients under 21, those with bilateral or unknown laterality, malignant neoplasms, fractures, or periprosthetic fractures, as well as patients who expired within 2 years post-discharge or lacked a 12-month baseline and follow-up. LEGION patients were identified through keyword analysis in billing records. A 1:5 propensity score matching was performed to balance the cohorts' baseline characteristics. Hospital-related clinical outcomes were then analyzed using generalized linear models. Kaplan-Meier survival analysis and Cox proportional hazards model were also used to assess revision outcomes.
RESULTS: The study matched 2,769 LEGION patients to 13,845 using other systems. Compared to patients without LEGION implants, patients with LEGION implants had shorter lengths of stay of index admission (Ratio=0.92; p<.0001). After index admission discharge, LEGION patients had lower odds of having all-cause inpatient readmission (OR=0.81; p=.0020, and OR=0.86; p=.0125) and fewer inpatient readmissions (Ratio=0.84; p=.0086, and Ratio=0.89; p=.0434) within 6 or 12 months. LEGION patients also had lower odds of developing knee infections or inflammatory reactions during the 12-month follow-up period. In addition, LEGION patients had a higher survival probability (p=.0113) and lower hazard (HR=0.73; p=.0117) for total re-revision post-discharge.
CONCLUSIONS: Retrospective data indicated that patients with LEGION with OxZr implants experienced shorter hospital stays, fewer inpatient readmissions, and less incidence of infections or total re-revision surgery. This information enables healthcare professionals and payors to make well-informed decisions regarding these critical choices about implant systems. ◊Trademark of Smith+Nephew. All Trademarks acknowledged.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
SA73
Topic
Study Approaches
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), STA: Surgery