Edoardo Franceschetti1, Guglielmo Torre2, Alessio Palumbo2, Rocco Papalia2, Jón Karlsson3, Olufemi R Ayeni4, Kristian Samuelsson3, Francesco Franceschi2. 1. Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128, Trigoria, Rome, Italy. e.franceschetti@unicampus.it. 2. Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128, Trigoria, Rome, Italy. 3. Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4. Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Abstract
PURPOSE: The present piece of work provides improved knowledge about the evidence related to TKA in patients 60 years of age or younger, with special focus on fixation methods. Main concern of the review is to analyse the difference of survival rate and complications of cemented and cementless implants. METHODS: An electronic search was carried out between October and December 2015, through CINAHL, PubMed and the Cochrane Central Registry of Controlled Trials web databases. Articles in English, Italian, French and Spanish were considered for inclusion. Only peer-reviewed studies with adult patients aged 60 years or less, with diagnosis of osteoarthritis in more than 90% of the subjects, were considered for inclusion. All studies had to report outcomes after TKA with either cemented or cementless fixation technique. RESULTS: No significant differences in terms of clinical, functional and radiological outcomes were found between cemented and cementless implants. Good clinical and functional results were obtained in terms of the Knee Society score and Western Ontario and McMaster Universities Osteoarthritis Index for both techniques. Radiographic results showed that radiolucent lines of <2 mm in width were detected at radiographs, without difference between cemented or cementless implants. Well-conducted trials on cemented versus cementless TKA were carried out in few papers. A survival rate of over 90% was reported in the majority of the studies at a mean follow-up of 8.6 years (range 5-18 years). CONCLUSION: Similar results were observed in terms of functional outcome and survival rates for both cemented and cementless TKAs. High survival rates were reported for both operative techniques and cemented TKA did not offer additional benefit. Assuming that cementless prosthesis allows a stable fixation and reduces the time of operation, the authors recommend the cementless fixation as a primary choice in the investigated patient population. However, evidence is low, and further research is needed. LEVEL OF EVIDENCE: IV.
PURPOSE: The present piece of work provides improved knowledge about the evidence related to TKA in patients 60 years of age or younger, with special focus on fixation methods. Main concern of the review is to analyse the difference of survival rate and complications of cemented and cementless implants. METHODS: An electronic search was carried out between October and December 2015, through CINAHL, PubMed and the Cochrane Central Registry of Controlled Trials web databases. Articles in English, Italian, French and Spanish were considered for inclusion. Only peer-reviewed studies with adult patients aged 60 years or less, with diagnosis of osteoarthritis in more than 90% of the subjects, were considered for inclusion. All studies had to report outcomes after TKA with either cemented or cementless fixation technique. RESULTS: No significant differences in terms of clinical, functional and radiological outcomes were found between cemented and cementless implants. Good clinical and functional results were obtained in terms of the Knee Society score and Western Ontario and McMaster Universities Osteoarthritis Index for both techniques. Radiographic results showed that radiolucent lines of <2 mm in width were detected at radiographs, without difference between cemented or cementless implants. Well-conducted trials on cemented versus cementless TKA were carried out in few papers. A survival rate of over 90% was reported in the majority of the studies at a mean follow-up of 8.6 years (range 5-18 years). CONCLUSION: Similar results were observed in terms of functional outcome and survival rates for both cemented and cementless TKAs. High survival rates were reported for both operative techniques and cemented TKA did not offer additional benefit. Assuming that cementless prosthesis allows a stable fixation and reduces the time of operation, the authors recommend the cementless fixation as a primary choice in the investigated patient population. However, evidence is low, and further research is needed. LEVEL OF EVIDENCE: IV.
Entities:
Keywords:
Arthroplasty; Knee; Knee surgery; Total knee arthroplasty; Young
Authors: James A Keeney; Selena Eunice; Gail Pashos; Rick W Wright; John C Clohisy Journal: Clin Orthop Relat Res Date: 2010-09-03 Impact factor: 4.176
Authors: Amar S Ranawat; Shubhranshu S Mohanty; Scott E Goldsmith; Vijay J Rasquinha; Jose A Rodriguez; Chitranjan S Ranawat Journal: J Arthroplasty Date: 2005-10 Impact factor: 4.757
Authors: Michael A Mont; Chang Woo Lee; Michael Sheldon; William C Lennon; David S Hungerford Journal: J Arthroplasty Date: 2002-08 Impact factor: 4.757
Authors: Lawrence Chun Man Lau; Elvis Chun Sing Chui; Gene Chi Wai Man; Ye Xin; Kevin Ki Wai Ho; Kyle Ka Kwan Mak; Michael Tim Yun Ong; Sheung Wai Law; Wing Hoi Cheung; Patrick Shu Hang Yung Journal: J Orthop Translat Date: 2022-10-06 Impact factor: 4.889
Authors: Avinesh Agarwalla; Joseph N Liu; David R Christian; Grant H Garcia; Gregory L Cvetanovich; Anirudh K Gowd; Adam B Yanke; Brian J Cole Journal: Cartilage Date: 2020-07-02 Impact factor: 3.117
Authors: Mika J Niemeläinen; Keijo T Mäkelä; Otto Robertsson; Annette W-Dahl; Ove Furnes; Anne M Fenstad; Alma B Pedersen; Henrik M Schrøder; Aleksi Reito; Antti Eskelinen Journal: Acta Orthop Date: 2020-01-13 Impact factor: 3.717
Authors: Dong Jin Ryu; Chung-Hee Sonn; Da Hee Hong; Kyeu Back Kwon; Sang Jun Park; Hun Yeong Ban; Tae Yang Kwak; Dohyung Lim; Joon Ho Wang Journal: Materials (Basel) Date: 2020-01-19 Impact factor: 3.623