Cemented, cementless or hybrid fixation options in total knee arthroplasty for osteoarthritis and other non-traumatic diseases

Nakama, Gilberto Yoshinobu; Peccin, Maria Stella; Almeida, Gustavo J.; Neto, Ozório de Almeida Lira; Queiroz, Antônio Altenor Bessa de; Navarro, Ricardo Dizioli

doi:10.1002/14651858.cd006193.pub2

Cited by 79 publications

(85 citation statements)

References 35 publications

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“…These small differences observed in the KSS and the WOMAC score seem to give a slight advantage to the group that received the cementless tibia. This tendency favoring cementless components has been observed by some authors in studies comparing cemented versus cementless implants (Table 5), although none of the differences observed in the comparison of these two types of implants attained statistical significance [7,8,14,23,30,42,46,67]. In the same sense, the minor differences observed in our study, although being statistically significant, raise the question of their clinical significance and the relevance of using such expensive technology.…”

Section: Discussionsupporting

confidence: 83%

Trabecular Metal in Total Knee Arthroplasty Associated with Higher Knee Scores: A Randomized Controlled Trial

Fernández-Fairén

Hernández-Vaquero

Murcia

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Porous tantalum is an option of cementless fixation for TKA, but there is no randomized comparison with a cemented implant in a mid-term followup. Questions/purposes We asked whether a tibial component fixed by a porous tantalum system might achieve (1) better clinical outcome as reflected by the Knee Society Score (KSS) and WOMAC Osteoarthritis Index, (2) fewer complications and reoperations, and (3) improved radiographic results with respect to aseptic loosening compared with a conventional cemented implant.Methods We randomized 145 patients into two groups, either a porous tantalum cementless tibial component group (Group 1) or cemented conventional tibial component in posterior cruciate retaining TKA group (Group 2). Patients were evaluated preoperatively and 15 days, 6 months, and 5 years after surgery, using the KSS and the WOMAC index. Complications, reoperations, and radiographic failures were tallied. Results At 5-year followup the KSS mean was 90.4 (range, 68-100; 95% CI, ± 1.6) for Group 1, and 86.5 (range, 56-99; 95% CI, ± 2.4) for Group 2. The effect size, at 95% CI for the difference between means, was 3.88 ± 2.87. The WOMAC mean was 15.1 (range, 0-51; 95% CI, ± 2.6) for the Group 1, and 19.1 (range, 4-61; 95% CI, ± 2.9) for Group 2. The effect size for WOMAC was À4.0 ± 3.9. There were no differences in the frequency of complications or in aseptic loosening between the two groups. Conclusions Our data suggest there are small differences between the uncemented porous tantalum tibial component and the conventional cemented tibial component. It currently is undetermined whether the differences outweigh the cost of the implant and the results of their long-term performance.

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Section: Discussionsupporting

confidence: 83%

Trabecular Metal in Total Knee Arthroplasty Associated with Higher Knee Scores: A Randomized Controlled Trial

Fernández-Fairén

Hernández-Vaquero

Murcia

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…A total of 19 % of our patients had morbid obesity (BMI>40), which is a percentage similar to published series [23][24][25][26][27][28][29][30][31]. Also, 18 % of our patients had diabetes mellitus, and 9.3 % were rheumatic patients.…”

Section: Discussionsupporting

confidence: 87%

Predictive factors for failure after total knee replacement revision

Luque

Rizo

Urda

et al. 2014

International Orthopaedics (SICOT)

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Purpose We used the Optetrak Condylar Constrained (CCK) implant, a modular and constrained knee implant as replacement for a failed primary arthroplasty, to assess the survivorship, the complications, the clinical, radiological, and functional situation, and the quality of life of those patients in whom a CCK had been implanted in recent years in order to find predictive pre-operative conditions of survival and clinical outcomes. Methods We performed a retrospective study of 125 CCK implanted between 1999 and 2005. The mean follow-up was nine years (range, seven to 13). Mean age was 73.6 years. A total of 78 % of the revised TKA were cemented and 66 % were CR. We assessed the pre-operative, the operative and the postoperative conditions studying the medical files of all the patients. In order to study the functional and clinical situation we used the Hospital for Special Surgery (HSS) score and the Knee Society score (KSS), both clinical and functional. We analysed all the X-rays using the Knee Society Roentgenographic evaluation. The quality of life was studied using the Oxford knee score (OKS). Results The mean results of the KSS clinical and the KSS functional were 68.24 and 63.85, respectively. There were not any conditions associated with poor results of the knees (p>0.05). The global survival at 24 months was 92.7 %, at 60 months 87.8 % and at 96 months it was 87.8 %. There were some conditions associated with poor survival of the knees, e.g. patients were younger than 70 years old, rheumatic diseases, kidney faliure, tibial tuberosity osteotomy, PS primary arthroplasty, revision before five years and septic loosening.Conclusions Based on these results there are some preoperative factors that change the survival of the total knee replacement revision.

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“…In total hip arthroplasty, cementless fixation of the femoral stem is achieved by direct contact with cortical bone, which has produced good clinical outcomes. In sharp contrast, the results of cementless total knee arthroplasty have been mixed, and the indications for its use are limited [7][8][9][10][11][12] . The tibial component in total knee arthroplasty relies on cancellous bone to achieve initial stability, and long-term failure of the bone-implant interface leading to aseptic loosening of the tibial component remains a major clinical challenge.…”

mentioning

confidence: 99%

Intermittent Parathyroid Hormone Enhances Cancellous Osseointegration of a Novel Murine Tibial Implant

Yang

Ricciardi

Dvorzhinskiy

et al. 2015

The Journal of Bone and Joint Surgery

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Cemented, cementless or hybrid fixation options in total knee arthroplasty for osteoarthritis and other non-traumatic diseases

Cited by 79 publications

References 35 publications

Trabecular Metal in Total Knee Arthroplasty Associated with Higher Knee Scores: A Randomized Controlled Trial

Trabecular Metal in Total Knee Arthroplasty Associated with Higher Knee Scores: A Randomized Controlled Trial

Predictive factors for failure after total knee replacement revision

Intermittent Parathyroid Hormone Enhances Cancellous Osseointegration of a Novel Murine Tibial Implant

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