Cemented vs Uncemented Femoral Components: A Randomized, Controlled Trial at 10 Years Minimum Follow-Up

Batailler, Cécile; Malemo, Yves; Demey, Guillaume; Kenney, Raymond; Lustig, Sébastien; Servien, Elvire

doi:10.1016/j.arth.2020.03.043

Cited by 19 publications

(21 citation statements)

References 56 publications

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“…1,123 patients (age range 41–90 years) were enrolled from 8 RCTs [ 25 – 32 ] conducted between 2001 and 2020. After over 8.8 years of follow-up (range 8.8–16.6 years), 984 knees at the last follow-up were included.…”

Section: Resultsmentioning

confidence: 99%

“…We assessed the implant survival of cemented ( n = 457) and cementless ( n = 425) fixation of TKA by grouping together the survivorship at the last follow-up in 6 studies [ 25 – 27 , 29 , 30 , 32 ]. After using a fixed effect model ( I 2 = 0%), the pooled data revealed the survivorship of the cementless fixation group of patients at a minimum of 8 years follow-up that was comparable to the cemented fixation group (RR, 1.016; 95% CI 0.978 to 1.056; P = 0.417) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…We assessed the KS knee score of cemented ( n = 298) and cementless ( n = 317) fixation of TKA by grouping together the KS knee score at last follow-up in 6 studies [ 27 – 32 ]. After applying a fixed effect model ( I 2 = 41.8%), the pooled data indicated the KS knee score of cementless fixation group at minimum 8.8 years of follow-up is comparable to that of cemented fixation group (SMD − 0.107; 95% CI − 0.259 to 0.045; P = 0.168) (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Long-term effects of cemented and cementless fixations of total knee arthroplasty: a meta-analysis and systematic review of randomized controlled trials

Chen

Shi

et al. 2021

J Orthop Surg Res

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Background To determine the long-term effects (a minimum follow-up time 8.8 years) of cemented and cementless fixations used for total knee arthroplasty (TKA). Methods PubMed, EMBASE, Ovid, Cochrane Library, CINAHL, China National Knowledge Infrastructure and China Wangfang database were interrogated for appropriate randomized controlled trials (RCTs) through July 2020. Data were extracted and assessed for accuracy by 2 of the authors acting independently. Any controversial discrepancies were resolved after discussion with a third author. Result Eight RCTs were included with low to moderate bias risks. The cemented fixation of TKA was comparable to cementless fixation in terms of implant survival (relative risk, 1.016; 95% CI 0.978 to 1.056; P = 0.417), Knee Society (KS) knee score (standardized mean difference (SMD), − 0.107; 95% CI − 0.259 to 0.045; P = 0.168), KS function score (SMD − 0.065; 95% CI − 0.238 to 0.109; P = 0.463), KS pain score (SMD − 0.300; 95% CI − 0.641 to 0.042; P = 0.085), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (SMD − 0.117; 95% CI − 0.307 to 0.073; P = 0.227), HSS score (SMD − 0.027; 95% CI − 0.270 to 0.217; P = 0.829), range of motion (SMD 0.061; 95% CI − 0.205 to 0.327; P = 0.652) at ≥ 8.8 years of follow-up. In terms of radiographic outcomes at ≥ 8.8 years of follow-up, the incidence of a radiolucent line in the cementless group was lower than for the cemented group (SMD 3.828; 95% CI 2.228 to 6.576; P < 0.001). However, the maximum total point motion (MTPM) of the cementless group was greater than for the cemented group (SMD − 0.739; 95% CI − 1.474 to − 0.005; P = 0.048). Conclusions Long-term follow-up verified that cementless and cemented fixation have similar prosthesis survival rates, clinical scores and mobility. However, radiography suggested that each technique had an advantage with regard to the radiolucent line and MTPM.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Long-term effects of cemented and cementless fixations of total knee arthroplasty: a meta-analysis and systematic review of randomized controlled trials

Chen

Shi

et al. 2021

J Orthop Surg Res

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“…We acknowledge several limitations to this study. Given that a total knee replacement has a reported survival rate of 98% at 10 years postoperatively (Argenson et al 2013, Jauregui et al 2015, Brockett et al 2018, Batailler et al 2020, and a total hip replacement reported 97% survival rates at 10 years postoperatively (Kremers et al 2012, Fowler et al 2019, Chaudhry et al 2020, by only measuring joint complications through the 90-day post-discharge period, this study is limited to only short-term data and excludes long-term complications. Another limitation is the lack of data within PearlDiver regarding the type of anesthesia used on MG patients during the arthroplasties; specifically, the codes used to indicate a spinal/epidural block did not delineate whether or not a patient also received general anesthesia, which may increase the rate of complications when compared with spinal anesthesia alone (Warren et al 2020).…”

Section: Discussionmentioning

confidence: 99%

“… 2018 , Batailler et al. 2020 ), and a total hip replacement reported 97% survival rates at 10 years postoperatively (Kremers et al. 2012 , Fowler et al.…”

Section: Discussionmentioning

confidence: 99%

Increased rate of complications in myasthenia gravis patients following hip and knee arthroplasty: a nationwide database study in the PearlDiver Database on 257,707 patients

Sherman

Ofa

et al. 2021

Acta Orthopaedica

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Background and purpose — The increasing prevalence of total hip arthroplasty (THA) and total knee arthroplasty (TKA) within the growing elderly population is translating into a larger number of patients with neuromuscular conditions such as myasthenia gravis (MG) receiving arthroplasty. We compared systemic and joint complications following a THA or TKA between patients with MG and patients without MG. Patients and methods — Patient records were queried from PearlDiver (Pearl Diver Inc, Fort Wayne, IN, USA), an administrative claims database, using ICD-9/ICD-10 and Current Procedural Terminology codes. In-hospital and 90-day post-discharge rates of systemic and joint complications were compared between the 2 cohorts. Results — 372 patients with MG and 249,428 patients without MG who received a THA or TKA were included in the study. At 90 days post-discharge, MG patients exhibited exhibited between 1.6 and 15% higher rates of systemic complications, including cerebrovascular event, pneumonia, respiratory failure, sepsis, myocardial infarction, acute renal failure, anemia, and deep vein thrombosis (all p < 0.001). The same results were also found during the in-hospital time period. 90-day incidence of aseptic loosening was the only joint complication with significantly increased odds risk for the MG cohort (OR 5; 95% CI 2–12). Interpretation — Patients with MG exhibited significantly higher risk for multiple systemic complications during the index hospital stay and in the acute post-discharge setting.

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Long-term outcomes were similar between hybrid and cemented TKAs performed on paired knees at a minimum 15 years of follow-up

Song

Lee

Bae³

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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PurposeTo compare long‐term clinical and radiographic results and survival rates between hybrid and cemented total knee arthroplasties (TKAs) performed on paired knees. MethodsSeventy‐two patients with hybrid and cemented TKAs performed on paired knees with NexGen® cruciate‐retaining prostheses were retrospectively reviewed after a minimum 15 years of follow‐up. Mean follow‐up period was 17.5 years. Preoperative alignment deformity and range of motion (ROM) were not different between groups. The Knee Society score, Western Ontario and McMaster Universities Osteoarthritis Index, and ROM were evaluated. Radiographically, change in joint space width, component loosening, and osteolysis were evaluated. Implant survival rate was analyzed. ResultsThere were no significant differences in clinical results between hybrid and cemented TKAs performed on paired knees of 72 patients at the last follow‐up. No significant difference was observed in the change in joint space width between the two groups at the last follow‐up (medial = 0.3 mm vs. 0.4 mm; lateral = 0.1 mm vs. 0.2 mm). One hybrid TKA showed tibial component loosening, for which revision was performed. There was femoral osteolysis in one hybrid and one cemented TKA, and tibial osteolysis in eight hybrid TKAs and seven cemented TKAs (n.s., respectively). The 20‐year survival rate was 97.7% for hybrid TKAs and 100% for cemented TKAs (n.s.). ConclusionThe long‐term outcomes were similar between hybrid and cemented TKAs performed on paired knees at a minimum 15 years of follow‐up. The method of femoral component fixation did not have a significant effect on long‐term TKA success. Level of evidence III.

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Cemented vs Uncemented Femoral Components: A Randomized, Controlled Trial at 10 Years Minimum Follow-Up

Cited by 19 publications

References 56 publications

Long-term effects of cemented and cementless fixations of total knee arthroplasty: a meta-analysis and systematic review of randomized controlled trials

Long-term effects of cemented and cementless fixations of total knee arthroplasty: a meta-analysis and systematic review of randomized controlled trials

Increased rate of complications in myasthenia gravis patients following hip and knee arthroplasty: a nationwide database study in the PearlDiver Database on 257,707 patients

Long-term outcomes were similar between hybrid and cemented TKAs performed on paired knees at a minimum 15 years of follow-up

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