Comparison of Cementless and Hybrid Cemented Total Knee Arthroplasty

Lass, Richard; Kubista, Bernd; Holinka, Johannes; Pfeiffer, Martin; Schuller, Spiro; Stenicka, Sandra; Windhager, Reinhard; Giurea, Alexander

doi:10.3928/01477447-20130327-16

Cited by 17 publications

(5 citation statements)

References 55 publications

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“…Similar to findings from this study, there is increasing literature demonstrating comparable outcomes between cementless and cemented TKAs. [16][17][18][19]31 Kamath et al 16 prospectively studied 100 cementless TKAs and compared them to 312 concurrent cemented controls with minimum 5-year follow-up. Implant failure rates were similar between the two cohorts with three (3%) clinical failures in the cementless cohort and five (2%) clinical failures in the cemented cohort.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Infection in Cementless and Cemented Total Knee Arthroplasty: A Propensity Score Matched Analysis

et al. 2019

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The ongoing debate on fixation in total knee arthroplasty (TKA) has become increasingly relevant with its increased use in a younger patient population and the advent of novel cementless prostheses. Recent literature suggests modern cementless implants are comparable to their cemented counterparts in terms of survivorship and functional outcomes. What has not been well-assessed is whether the two modalities differ with respect to infection rates which was the purpose of this study. Specifically, a propensity score matched study population was used to compare: (1) overall infection; (2) prosthetic joint infection (PJI); and (3) surgical site infection (SSI) rates between cementless and cemented TKAs. Using a large institutional database, 3,180 consecutive primary TKAs were identified. Cementless and cemented TKA patients were propensity score matched by age (p = 0.069), sex (p = 0.395), body mass index (BMI; p = 0.308), and Charlson's comorbidity index (CCI) score (p = 0.616) in a 1:1 ratio. Univariate analysis was performed to compare 2-year overall infection rates. Infections were further analyzed separately as PJIs (deep joint infections requiring surgery) and SSIs (skin/superficial wound infections). Multivariate logistic regression was performed to evaluate infection incidences after adjusting for procedure-related factors (i.e., operative time, hospital volume, and surgeon volume). There were no significant differences between the matched cohorts in terms of overall infection rates (3.8 vs. 2.3%, p = 0.722), as well as when PJI (p = 1.000) and SSI (p = 1.000) rates were analyzed separately. Multivariate analysis revealed no significant differences in overall postoperative infection rates (p = 0.285), PJI rates (p = 0.446), or SSI rates (p = 0.453) even after adjusting for procedure-related factors. There is increasing literature investigating various outcomes demonstrating the comparable efficacies of cementless versus cemented TKAs. To the best of the author's knowledge, this was the first matched case-control study to directly compare their post-operative infection rates. The findings from this study show that post-operative infection rates were similar between fixation modalities even after accounting for a range of patient- and procedure-related factors.

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Section: Discussionmentioning

confidence: 99%

Postoperative Infection in Cementless and Cemented Total Knee Arthroplasty: A Propensity Score Matched Analysis

et al. 2019

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“…At 6-year mean follow-up, no significant difference existed between the cementless and hybrid cemented tibial components in TKA in terms of clinical and functional results and postoperative complications. The significantly smaller number of radiolucent lines in the cementless group is an indicator of primary stability with the benefit of longterm fixation durability of TKA (20).…”

Section: In Favor Of Cementless Fixation There Are Many Recent Workmentioning

confidence: 98%

Cementless total knee arthroplasty

Aprato¹,

Risitano²,

Sabatini³

et al. 2016

Ann. Transl. Med.

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Interest for uncemented total knee arthroplasty (TKA) has greatly increased in recent years. This technique, less used than cemented knee replacement in the last decades, sees a revival thanks an advance in prosthetic design, instrumentation and operative technique. The related literature in some cases shows conflicting data on survival and on the revision's rate, but in most cases a success rate comparable to cemented TKA is reported. The optimal fixation in TKA is a subject of debate with the majority of surgeons favouring cemented fixation.

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“…The choice between cementless and conventional cemented fixation for TKA has been a matter of debate ever since the introduction of cementless systems in the 1970s [3, 18, 22, 30]. Designed in response to the risk of cement–bone interface degradation and implant loosening with cemented systems, the biological interaction between the bone and implant in cementless TKA aims to promote osseointegration and ensure subsequent long‐term fixation, particularly in younger, active patients [2].…”

Section: Introductionmentioning

confidence: 99%