Cemented versus cementless Oxford unicompartmental knee arthroplasty using radiostereometric analysis

Abstract

The most common reasons for revision of unicompartmental knee arthroplasty (UKA) are loosening and pain. Cementless components may reduce the revision rate. The aim of this study was to compare the fixation and clinical outcome of cementless and cemented Oxford UKAs. A total of 43 patients were randomised to receive either a cemented or a cementless Oxford UKA and were followed for two years with radiostereometric analysis (RSA), radiographs aligned with the bone-implant interfaces and clinical scores. The femoral components migrated significantly during the first year (mean 0.2 mm) but not during the second. There was no significant difference in the extent of migration between cemented and cementless femoral components in either the first or the second year. In the first year the cementless tibial components subsided significantly more than the cemented components (mean 0.28 mm (sd 0.17) vs. 0.09 mm (sd 0.19 mm)). In the second year, although there was a small amount of subsidence (mean 0.05 mm) there was no significant difference (p = 0.92) between cemented and cementless tibial components. There were no femoral radiolucencies. Tibial radiolucencies were narrow (< 1 mm) and were significantly (p = 0.02) less common with cementless (6 of 21) than cemented (13 of 21) components at two years. There were no complete radiolucencies with cementless components, whereas five of 21 (24%) cemented components had complete radiolucencies. The clinical scores at two years were not significantly different (p = 0.20). As second-year migration is predictive of subsequent loosening, and as radiolucency is suggestive of reduced implant-bone contact, these data suggest that fixation of the cementless components is at least as good as, if not better than, that of cemented devices.

Mid-Term Evaluation of the Unicompartmental Knee Arthroplasty in Patients with BMI of 40 or Greater

“…Patient selection and technique are under The Journal of Knee Surgery size for each subgroup precludes making any definitive conclusions but the results are consistent with several studies that found no difference in the revision rates for cemented and cementless Oxford UKAs in patients with lower BMIs. 8,[24][25][26] While the impact of hybrid fixation is not described in the literature, our findings suggest that hybrid Oxford UKAs may be safe for implantation in patients with morbid obesity. Further study on the influence of fixation type on the survival of Oxford UKA in patients with morbid obesity is warranted.…”

The Interaction of Caseload and Usage in Determining Outcomes of Unicompartmental Knee Arthroplasty: A Meta-Analysis

“…New Zealand Not cemented Oxford Phase 3 Jahromi 2004 [85] Australia No survival data Kaczmarczyk 2003[86] Poland No survival data Kendrick 2015 [87] UK No survival data Kubat 2011 [88] Czech…”

Results after Cementless Medial Oxford Unicompartmental Knee Replacement - Incidence of Radiolucent Lines

“…A reduction of RL within the first year seems to be typical in cementless fixation which can be observed in other studies of cementless OUKR. [8, 20–22]. As explained by Hooper et al and Pandit et al, early radiolucencies might be ascribed to incompletely impacted implants which settle during weight-bearing.…”