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

Abstract

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.

Survivorship and complications of cementless compared to cemented posterior-stabilized total knee arthroplasties: A systematic review and meta-analysis

“…Only six studies were selected for full-text analysis and meta-analysis after eliminating screening duplicates, titles, and abstracts without full-text access. The bibliography analysis added two more studies, making a total of 8 citations that met the inclusion criteria for the analysis [1,[13][14][15][16][17][18][19]. Two studies were RCT [13,14] and six were non-RCT [1,[15][16][17][18][19].…”

“…The bibliography analysis added two more studies, making a total of 8 citations that met the inclusion criteria for the analysis [1,[13][14][15][16][17][18][19]. Two studies were RCT [13,14] and six were non-RCT [1,[15][16][17][18][19]. A summary of this process is provided in Figure 1, depicting the flow diagram of the selection process of studies eligible for the meta-analysis.…”

“…Four studies [1,14,15,18] reported the incidence of radiolucent lines. Radiographic knee score was employed across all studies to assess these radiolucent lines.…”