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Total knee replacement: should it be cemented or hybrid?

C H Rorabeck1

  • 1London Health Sciences Centre, University of Western Ontario, London. cecil.rorabeck@lhsc.on.ca

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|March 11, 1999
PubMed
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This study found no difference in complication rates for total knee arthroplasty using hybrid versus cemented fixation. The Anatomic Modular Knee prosthesis shows excellent medium-term results with a low reoperation rate.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Medical Device Engineering

Background:

  • Total knee arthroplasty (TKA) is a common procedure for end-stage knee osteoarthritis.
  • Fixation methods, including cemented, noncemented, and hybrid techniques, influence TKA outcomes.
  • The Anatomic Modular Knee (AMK) prosthesis is a specific TKA design with variable fixation options.

Purpose of the Study:

  • To compare complication rates between hybrid and cemented fixation methods for the AMK prosthesis.
  • To evaluate the medium-term clinical and radiographic outcomes of the AMK prosthesis based on fixation type.

Main Methods:

  • Prospective, nonrandomized, controlled trial involving 484 knees in 395 patients.
  • Two groups: hybrid fixation (cemented tibia, noncemented femur) and fully cemented fixation.

Related Experiment Videos

  • Clinical assessments using The Knee Society Clinical Rating Scores and radiographic analysis for alignment and implant integrity.

    • Main Results:

    • Average follow-up of 4.8 years with a reoperation rate of 1.6% (8 knees).
    • No significant difference in complications leading to reoperation between hybrid and cemented fixation groups.
    • Excellent medium-term outcomes reported for the AMK prosthesis.

    Conclusions:

    • Femoral component fixation (cemented vs. noncemented) does not impact TKA outcomes with the AMK prosthesis.
    • The AMK prosthesis demonstrates excellent medium-term efficacy with a low reoperation rate, regardless of fixation method.