Table of Contents
ISRN Biomaterials
Volume 2013, Article ID 174298, 7 pages
Research Article

Clinical and Radiographic Comparison of Oxidized Zirconium and Cobalt Chrome Femoral Components of a Single Design Primary Total Knee Arthroplasty: Is the Cost Difference Justified Based on Patient Outcomes?

1University of South Carolina School of Medicine Greenville, 701 Grove Road, Greenville, SC 29605, USA
2Clemson University Biomedical Engineering Innovation Campus, 200 Patewood Drive, Greenville, SC 29615, USA
3Greenville Health System, Department of Orthopedics, University of South Carolina SOM, 2nd Floor Support Tower, 701 Grove Road, P.O. Box 27114, Greenville, SC 29616, USA

Received 20 August 2013; Accepted 20 October 2013

Academic Editors: V. K. Balla, E. Gómez-Barrena, and B. Yang

Copyright © 2013 Geevan George et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A review of 120 consecutive total knee arthroplasty patient records was made comparing oxidized zirconium with traditional cobalt chrome alloy femoral components and assessing the clinical and radiographic outcomes of each. The direct hospital implant cost for each of these implant systems was obtained and assessed in the context of any difference in patient Knee Society Scores, knee flexion, pain, probability of metal allergy, and radiographic signs of pending implant failures. At an average of 5.6-year followup (1–11-year range in both groups), the data showed no clinical or radiological variance between the two groups, while the hospital direct implant cost with the oxidized zirconium femoral component was $1900 higher than the cobalt chrome implants. Considering the cost difference between the implants and the lack of a difference in outcomes at an average of 5-6 years of followup, this paper brings into question the ability to justify the use of oxidized zirconium femoral components based solely on improved patient outcomes.