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Cementless vs Cemented Tibial Fixation in Primary Total Knee Arthroplasty
Omar A Behery1, Sean M Kearns2, Justin M Rabinowitz2
1Department of Orthopaedics, Rush University Medical Center, Chicago, Illinois; Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, New York.
The Journal of Arthroplasty
|January 14, 2017
Summary
Cementless total knee arthroplasty (TKA) showed higher rates of aseptic loosening and revision surgery compared to cemented TKA within five years. Clinical outcome scores were similar between the two fixation methods.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
Background:
- The optimal fixation method for tibial components in total knee arthroplasty (TKA) is debated.
- Uncertainty exists regarding the equivalence of cementless versus cemented fixation in early TKA outcomes.
Purpose of the Study:
- To compare the early outcomes of cementless tibial components versus cemented fixation in TKA.
- To evaluate aseptic loosening, revision rates, and clinical outcome scores between fixation methods.
Main Methods:
- A retrospective matched-cohort study involving 70 cementless and 70 cemented TKA cases.
- Matching was based on implant design and patient demographics between 2008 and 2015.
Main Results:
- Cementless TKA exhibited significantly higher rates of aseptic loosening (7 vs 0, P=.013) and revision surgery (10 vs 0, P=.001) within five years.
- No significant differences in patient-reported outcome scores were observed between the groups.
Conclusions:
- Early aseptic loosening and revision surgery are more prevalent with cementless tibial fixation in TKA.
- Further research is needed to determine if improved adjunct fixation can mitigate early failures in cementless TKA and justify potential lifelong biologic ingrowth benefits.
