Similar Revision Rates for High- and Low-Viscosity Cement in Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Clinical Epidemiology

Background:

• Increasing use of high-viscosity cement in total knee arthroplasty (TKA).
• Literature suggests potential association between high-viscosity cement and higher failure rates.
• Need to evaluate viscosity-specific failure rates and antibiotic additive impact.

Purpose of the Study:

• To determine the frequency of high-viscosity cement use in TKA.
• To compare revision rates between high-viscosity and low-viscosity cement.
• To assess the influence of antibiotic additives on cement survival.

Main Methods:

• Retrospective cohort study utilizing statewide data (2012-2022).
• Classified 176,216 TKA cases by cement viscosity (high/medium/low).
• Kaplan-Meier curves for revision rates; analyzed antibiotic use impact.

Main Results:

• High-viscosity cement used in 57.9% of cases; low-viscosity in 39.8%.
• Revision rates were similar for high-viscosity and low-viscosity cement.
• Antibiotic-impregnated cement (43.1%) showed similar all-cause revision rates.

Conclusions:

• High-viscosity cement is prevalent in TKA, with comparable revision rates to low-viscosity cement.
• Medium-viscosity cement showed increased failure with low surgeon volume.
• Antibiotic use in cement did not significantly affect TKA survival rates.