Early inducible displacement of tibial components in total knee prostheses inserted with and without cement: a randomized study with roentgen stereophotogrammetric analysis.

The fixation of tibial components randomized to insertion with or without cement in twenty-six knees was examined for inducible displacement at six weeks and one year postoperatively with use of roentgen stereophotogrammetric analysis. Furthermore, migration was studied during the first two postoperative years. Inducible displacement was found in all knees at both the six-week and the one-year follow-up examination, but no differences were detected with respect to the type of fixation (p > 0.05). All tibial components migrated for as long as one year postoperatively, after which most stabilized. No difference was found between the groups with respect to migration during the first two years postoperatively (p > 0.05), with the exception of subsidence of the component, which was found to be 0.0+/-0.1 millimeter (mean and standard error of the mean) for the components inserted with cement and 0.5+/-0.1 millimeter for the components inserted without cement (p < 0.01). Migration after one year was the same for both groups. We found a relationship between inducible displacement at six weeks and at one year as well as one between inducible displacement and migration at one year. To our knowledge, the present study is the first in which the micromotion of an interference-fit prosthesis was found to be similar to that of a device inserted with cement. The results of the present study emphasize the importance of the initial prosthetic fixation.

RCT Entities:   Population Interventions Outcomes