A prospective evaluation of a largely cementless total knee arthroplasty cohort without patellar resurfacing: 10-year outcomes and survivorship

Napier, Richard J.; O’Neill, Christopher; O’Brien, Seamus; Doran, E.; Mockford, B J; Boldt, J.; Beverland, David

doi:10.1186/s12891-018-2128-1

Cited by 19 publications

(8 citation statements)

References 55 publications

(58 reference statements)

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“…Lastly, the mobile bearing insert may play a vital role to early osteointegration, reducing the stresses applied to the tibial implant-bone interface [5,24]. Bottlang et al reported that the mobile-bearing insert reduced torque in the proximal tibia during knee rotation by 68-73% compared with the ixed-bearing insert [4].…”

Section: Discussionmentioning

confidence: 99%

Modern cementless posterior stabilized mobile-bearing total knee arthroplasty shows comparable clinical and radiographical results to its cemented predecessor at 1-year follow-up

Mikashima

Imamura

Shirakawa

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to evaluate perioperative and short-term clinical and radiographical results of a modern PS mobile-bearing cementless TKA system. Methods A retrospective review of a consecutive series of TKAs was performed by a single surgeon using a cementless or cemented TKA of the same design (Attune, DePuy Synthes, Massachusetts, USA). The 2011 Knee Society Score, Forgotten Joint Score-12, Hip-Knee-Ankle angle, and the presence of radiolucent lines (RLLs) were reviewed 1-year postoperatively with 1:1 matching performed for age, gender, body mass index, and preoperative UCLA score. Fisher's exact test or independent Student's t-test were used for statistical analyses. Results Forty-ive cementless and 45 cemented TKAs were reviewed after 1:1 matching. The mean operative time was 8.8 min shorter (P < .01), and the mean amount of drainage was 40.0 ml greater (P = .04) in the cementless cohort. At 1-year postoperatively, there were no signiicant diferences in both cohorts in 2011 Knee Scores and Forgotten Joint Scores-12, with no patients requiring revision surgery (NS). The incidence of RLLs was signiicantly higher in cementless TKAs (51%) than that in cemented TKAs (22%, P < .01). However, the mean width of RLLs in the cementless TKAs (0.2 mm) was signiicantly smaller (P < .01) than that in the cemented TKAs (0.8 mm) at 1-year postoperatively with no progression. Conclusion A recently introduced cementless PS mobile-bearing TKA design demonstrated comparable postoperative and radiographical results to its cemented predecessor at 1-year follow-up. Level of Evidence Retrospective cohort study, Level III.

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Section: Discussionmentioning

confidence: 99%

Modern cementless posterior stabilized mobile-bearing total knee arthroplasty shows comparable clinical and radiographical results to its cemented predecessor at 1-year follow-up

Mikashima

Imamura

Shirakawa

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…The authors asserted that on review of the literature the incidence of instability and dislocation was much higher in fixed bearing prosthesis [46]. A 10-year survival of 98.9% has also been reported with only one aseptic loosening in 140 knees for a rotating platform design [47].…”

Section: R Otating Platform Versus Fi Xed Bearing Uncemented Tkrmentioning

confidence: 99%

Uncemented Total Knee Replacement- Rediscovering the Past

Rao¹,

Patil²,

Bansal³

2022

Jcorth

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Total knee replacements (TKR) both cemented and uncemented were developed almost simultaneously in the 1980’s. Cemented TKR found favor among the surgeons due to its technical ease and early failure of uncemented TKR due to poor design. In the past two decades; however, interest has been generated in uncemented TKR both because of design improvements which, in turn, has led to better results, especially in young active, obese, and geriatric but active patients where cemented TKR’s have been found to have increased failure rates. Active research is ongoing to refine the designs of uncemented TKR and future holds promise for this re-emerging technique and implant. This review helps to summarize the reasons for increasing interest in uncemented TKR, the newer designs and their results and the future developments expected.

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“…Advantages of cementless fixation are preservation of bone stock, provision of a biological fixation of the implant to the bone and avoidance of cement and its wear particles[54]. At 10 yr, a survival rate of 98.9% has been found[55]. In a recent meta-analysis, no difference could be found in terms of implant survivorship, clinical outcomes, radiological outcomes and complications between cemented and cementless implants[54].…”

Section: “Hypersensitivity-friendly” Implantsmentioning

confidence: 99%

Allergy in total knee replacement surgery: Is it a real problem?

Saccomanno¹,

Sircana²,

Masci³

et al. 2019

WJO

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Total knee arthroplasty is a common procedure, with extremely good clinical results. Despite this success, it produces 20% unsatisfactory results. Among the causes of these failures is metal hypersensitivity. Metal sensitization is higher in patients with a knee arthroplasty than in the general population and is even higher in patients undergoing revision surgery. However, a clear correlation between metal sensitization and symptomatic knee after surgery has not been ascertained. Surely, patients with a clear history of metal allergy must be carefully examined through dermatological and laboratory testing before surgery. There is no globally accepted diagnostic algorithm or laboratory test to diagnose metal hypersensitivity or metal reactions. The patch test is the most common test to determine metal hypersensitivity, though presenting some limitations. Several laboratory assays have been developed, with a higher sensitivity compared to patch testing, yet their clinical availability is not widespread, due to high costs and technical complexity. Symptoms of a reaction to metal implants present across a wide spectrum, ranging from pain and cutaneous dermatitis to aseptic loosening of the arthroplasty. However, although cutaneous and systemic hypersensitivity reactions to metals have arisen, thereby increasing concern after joint arthroplasties, allergies against implant materials remain quite rare and not a well-known problem. The aim of the following paper is to provide an overview on diagnosis and management of metal hypersensitivity in patients who undergo a total knee arthroplasty in order clarify its real importance.

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A prospective evaluation of a largely cementless total knee arthroplasty cohort without patellar resurfacing: 10-year outcomes and survivorship

Cited by 19 publications

References 55 publications

Modern cementless posterior stabilized mobile-bearing total knee arthroplasty shows comparable clinical and radiographical results to its cemented predecessor at 1-year follow-up

Modern cementless posterior stabilized mobile-bearing total knee arthroplasty shows comparable clinical and radiographical results to its cemented predecessor at 1-year follow-up

Uncemented Total Knee Replacement- Rediscovering the Past

Allergy in total knee replacement surgery: Is it a real problem?

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