Cemented versus uncemented fixation of the femoral component of the NexGen CR total knee replacement in patients younger than 60 years

Gao, Feng; Henricson, Anders; Nilsson, Kjell

doi:10.1016/j.knee.2008.11.009

Cited by 61 publications

(64 citation statements)

References 32 publications

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“…They include toxicity of PMMA [27], decreased bone stock at the time of revision, difficulty in the treatment after infection around the implants and weakening of the fixation over time [28]. As a result, various authors have advocated cementless fixation, especially for young and active patients [29,30], and some retrospective studies have reported better results for cementless fixation compared to cemented [31,32]. The main disadvantage of the cementless fixation, however, is poor fixation in the early period after the implantation.…”

Section: Resultsmentioning

confidence: 99%

Early Fixation of Cobalt-Chromium Based Alloy Surgical Implants to Bone Using a Tissue-engineering Approach

Ogawa

Tohma

Ohgushi

et al. 2012

IJMS

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To establish the methods of demonstrating early fixation of metal implants to bone, one side of a Cobalt-Chromium (CoCr) based alloy implant surface was seeded with rabbit marrow mesenchymal cells and the other side was left unseeded. The mesenchymal cells were further cultured in the presence of ascorbic acid, β-glycerophosphate and dexamethasone, resulting in the appearance of osteoblasts and bone matrix on the implant surface. Thus, we succeeded in generating tissue-engineered bone on one side of the CoCr implant. The CoCr implants were then implanted in rabbit bone defects. Three weeks after the implantation, evaluations of mechanical test, undecalcified histological section and electron microscope analysis were performed. Histological and electron microscope images of the tissue engineered surface exhibited abundant new bone formation. However, newly formed bone tissue was difficult to detect on the side without cell seeding. In the mechanical test, the mean values of pull-out forces were 77.15 N and 44.94 N for the tissue-engineered and non-cell-seeded surfaces, respectively. These findings indicate early bone fixation of the tissue-engineered CoCr surface just three weeks after implantation.

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Section: Resultsmentioning

confidence: 99%

Early Fixation of Cobalt-Chromium Based Alloy Surgical Implants to Bone Using a Tissue-engineering Approach

Ogawa

Tohma

Ohgushi

et al. 2012

IJMS

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“…Potential advantages to the use of hybrid fixation in total knee replacement have been well described in previous studies, with acceptable outcomes demonstrated at short to intermediate term followup [1, 7–13, 15]. Campbell et al previously reported on a series of 65 TKAs with 7.4-year followup demonstrating high rates of early femoral component loosening and failures [16].…”

Section: Discussionmentioning

confidence: 99%

“…Failures of the tibial component and patellar component have been shown to be problematic with cementless fixation [2, 4–6]. Many studies of hybrid fixation, with cemented tibial and patellar components and cementless femoral fixation, have shown positive results [1, 7–15]. One group reported an unacceptably high revision rate at 15 year followup and concluded that hybrid fixation should be abandoned [16, 17].…”

Section: Introductionmentioning

confidence: 99%

Hybrid Total Knee Arthroplasty Revisited: Midterm Followup of Hybrid versus Cemented Fixation in Total Knee Arthroplasty

Pelt

Gililland

Doble

et al. 2013

BioMed Research International

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The optimal method of fixation in total knee arthroplasty is still debated. Hybrid total knee arthroplasty (TKA), with cemented tibial and cementless femoral components, is a proposed method of fixation to improve outcomes. Although several studies have shown favorable outcomes, there is still lack of consensus in the literature. We hypothesized that hybrid TKA yields similar clinical, radiographic, and survivorship results compared to fully cemented TKA. The clinical and radiographic outcomes of 304 cruciate retaining TKAs with minimum two-year followup, including 193 hybrid (mean followup of 4.1 years) and fully cemented TKAs (mean followup of 3.2 years) were evaluated. Knee society scores were similar between the two groups. The total number of femoral radiolucencies was also similar between the two groups, while a greater number of femoral Zone 4 radiolucencies were seen in the cemented group (9% versus 1.6%, P = 0.005). The hybrid group demonstrated a 99.2% survival rate of the femoral component out to seven years for aseptic loosening. No significant difference in survivorship was seen between the groups for all cause or aseptic failure at seven years. We conclude that hybrid fixation leads to similar intermediate-term outcomes as fully cemented components and remains a viable option in total knee arthroplasty.

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“…6 patients underwent simultaneous bilateral TKR, 4 with the TM tibia and 2 with the cemented tibia (Table 1). The femoral component was either a cemented or an uncemented NexGen implant, which has been the subject of another study (Gao et al 2009). The femoral component had a titanium fiber-mesh non-articular surface.…”

Section: Methodsmentioning

confidence: 99%

Trabecular metal tibia still stable at 5 years

Henricson¹,

Rösmark²,

Nilsson³

2013

Acta Orthopaedica

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Background and purpose Clinical results of total knee replacement (TKR) are inferior in younger patients, mainly due to aseptic loosening. Coating of components with trabecular metal (TM) is a new way of enhancing fixation to bone. We have previously reported stabilization of TM tibial components at 2 years. We now report the 5-year follow-up of these patients, including RSA of their TM tibial components.Patients and methods 22 patients (26 knees) received an uncemented TM cruciate-retaining tibial component and 19 patients (21 knees) a cemented NexGen Option cruciate-retaining tibial component. Follow-up with RSA, and clinical and radiographic examinations were done at 5 years. In bilaterally operated patients, the statistical analyses included only the first-operated knee.Results Both groups had most migration within the first 3 months, the TM implants to a greater extent than the cemented implants. After 3 months, both groups stabilized and remained stable up to the 5-year follow-up.Interpretation After a high initial degree of migration, the TM tibia stabilized. This stabilization lasted for at least 5 years, which suggests a good long-term performance regarding fixation. The cemented NexGen CR tibial components showed some migration in the first 3 months and then stabilized up to the 5-year follow-up. This has not been reported previously.

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Cemented versus uncemented fixation of the femoral component of the NexGen CR total knee replacement in patients younger than 60 years

Cited by 61 publications

References 32 publications

Early Fixation of Cobalt-Chromium Based Alloy Surgical Implants to Bone Using a Tissue-engineering Approach

Early Fixation of Cobalt-Chromium Based Alloy Surgical Implants to Bone Using a Tissue-engineering Approach

Hybrid Total Knee Arthroplasty Revisited: Midterm Followup of Hybrid versus Cemented Fixation in Total Knee Arthroplasty

Trabecular metal tibia still stable at 5 years

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