Cécile Batailler1, Yves Malemo1, Guillaume Demey2, Raymond Kenney3, Sébastien Lustig4, Elvire Servien5. 1. Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France. 2. Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France; Lyon-Ortho-Clinic, Clinique de la Sauvegarde, Lyon, France. 3. Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France; Department of Orthopaedics, University of Rochester Medical Center, Rochester, NY. 4. Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France; Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, Villeurbanne, France. 5. Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France; EA 7424, Interuniversity Laboratory of Human Movement Science, Université Lyon 1, Lyon, France.
Abstract
BACKGROUND: The type of total knee arthroplasty (TKA) fixation (cemented or uncemented) is still subject to debate. The aim of this study is to assess the survival rate, clinical outcomes, and radiological results of TKA according to the fixation type. METHODS: A total of 130 patients were randomly assigned to either the cement group (cemented femoral and tibial implants) or the hybrid group (cemented tibial implant, uncemented femoral implant). The inclusion criteria were patients between 50 and 90 years old who underwent primary TKA for osteoarthritis between 2004 and 2005 without a history of open knee surgery. Revisions and complications were reported, as well as clinical scores and radiological signs of loosening. RESULTS:One hundred eighteen patients had complete data at 10 years of minimum follow-up (59 in each group). The mean age was 72 years old. The mean follow-up was 13 years. The survival rate was 98% at 13 years in both groups (1 aseptic loosening at 2 years in the cement group, 1 septic loosening in the hybrid group). The complication rate in the cement group was 8.5% (n = 5) vs 12.1% (n = 7) in the hybrid group (P = .8). The clinical results were not significantly different. In the cement group, 25% of patients (n = 15) had radiolucent lines at 10 years. In the hybrid group, 33% of patients had bone transparencies, not evolving or symptomatic. CONCLUSION: At a minimum follow-up of 10 years, there were no significant differences between cemented TKA and hybrid TKA for the survivorship, the complication rate, the clinical scores, or the radiological signs of loosening. LEVEL OF EVIDENCE: I.
RCT Entities:
BACKGROUND: The type of total knee arthroplasty (TKA) fixation (cemented or uncemented) is still subject to debate. The aim of this study is to assess the survival rate, clinical outcomes, and radiological results of TKA according to the fixation type. METHODS: A total of 130 patients were randomly assigned to either the cement group (cemented femoral and tibial implants) or the hybrid group (cemented tibial implant, uncemented femoral implant). The inclusion criteria were patients between 50 and 90 years old who underwent primary TKA for osteoarthritis between 2004 and 2005 without a history of open knee surgery. Revisions and complications were reported, as well as clinical scores and radiological signs of loosening. RESULTS: One hundred eighteen patients had complete data at 10 years of minimum follow-up (59 in each group). The mean age was 72 years old. The mean follow-up was 13 years. The survival rate was 98% at 13 years in both groups (1 aseptic loosening at 2 years in the cement group, 1 septic loosening in the hybrid group). The complication rate in the cement group was 8.5% (n = 5) vs 12.1% (n = 7) in the hybrid group (P = .8). The clinical results were not significantly different. In the cement group, 25% of patients (n = 15) had radiolucent lines at 10 years. In the hybrid group, 33% of patients had bone transparencies, not evolving or symptomatic. CONCLUSION: At a minimum follow-up of 10 years, there were no significant differences between cemented TKA and hybrid TKA for the survivorship, the complication rate, the clinical scores, or the radiological signs of loosening. LEVEL OF EVIDENCE: I.
Authors: Laurian J M van Es; Inger N Sierevelt; Daniël Hoornenborg; Bas van Ooij; Daniël Haverkamp Journal: Indian J Orthop Date: 2022-08-22 Impact factor: 1.033