Cement or cementless fixation in total knee arthroplasty?

Area of Science:

• Orthopedic surgery
• Biomaterials engineering
• Medical device technology

Background:

• Cement fixation has been the traditional method for knee prostheses.
• Cementless fixation offers potential advantages like bone ingrowth and easier revision.
• The Press Fit Condylar prosthesis is a commonly used implant for total knee arthroplasty.

Purpose of the Study:

• To compare the early clinical and radiographic outcomes of cementless versus cemented fixation for the Press Fit Condylar prosthesis.
• To evaluate differences in complication rates and implant survival between the two fixation methods.

Main Methods:

• A prospective study of 59 cementless knees was compared to a matched retrospective cohort of 59 cemented knees.
• Patients received the Press Fit Condylar prosthesis.
• Follow-up averaged 2.8 years, assessing knee scores, radiolucency, and complications.

Main Results:

• No significant differences in knee scores were observed between cementless and cemented groups at 2.8 years.
• Radiolucent lines adjacent to the tibial component were similar in both fixation groups.
• The cementless group had a higher complication rate (20%) compared to the cemented group (12%), primarily due to polyethylene wear in metal-backed patellar components.

Conclusions:

• Cement or cementless fixation of the Press Fit Condylar prosthesis provides equivalent early clinical results.
• Cementless fixation may be associated with a higher risk of early complications, particularly polyethylene wear.