Similar patient-reported outcomes for hybrid and cemented stem fixation for aseptic tibial revision total knee arthroplasty: a comparison of sequential prospective cohorts

Abstract

PurposeThe tibial stem fixation in an aseptic revision of total knee arthroplasty is poorly studied and controversial. The objective of this study was to prospectively compare clinical outcomes between hybrid and cemented fixation of the stem in aseptic tibial revision after a minimum follow‐up of 5 years. MethodsTwo sequential prospective cohorts of patients who underwent aseptic tibial revision were compared after a minimum follow‐up of five years: 31 had both tibial tray and stem cemented (cemented group), and 42 had a hybrid fixation with tibial tray cemented and stem cementless (hybrid group). Clinical assessment was performed by the Knee Society Scores and reduced Western Ontario and McMaster Universities Arthritis Index. Radiological assessment was also performed. ResultsThere were no significant differences in preoperative data between groups. Postoperatively, no significant differences between groups in clinical scores or complication rate were found. Survival of the TKA revision at 5‐year was 94% (95% CI 89–98%) in the cemented group, and 98% (95% CI 92–100%) in the hybrid group (ns). ConclusionClinical outcomes and implant survival were comparable between hybrid and cemented tibial stem fixation. Level of evidenceII.

Cemented versus Cementless Stem Fixation in Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

“…Despite this significant discrepancy, there were no statistically significant differences between the two groups concerning clinical scores including KSS, WOMAC and range of motion. This goes in line with literature data confirming the absence of correlation between appearance of radiolucencies or radiolucent lines and clinical scores or implant survival [28,38,40,43].…”

“…Forest plots showing incidence of radiolucent lines. The upper chart represents data from studies involving patients with cemented stem fixation and the lower chart represents data from studies with cementless stem fixation fixation (n-sample size, P %-Proportion, CI-Confidence interval, W %-Weight (Random)) [7,16,[18][19][20][21][22]26,28,[35][36][37][38][39][40]42,43,45,48,49].…”

“…The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was also not significantly different between the two groups (75.65 ± 8.03 points in the cemented group versus 82.36 ± 3.01 points in the cementless group, p = 0.3235). Similarly, there were no significant differences regarding range of motion with mean 96.09 [7,16,[18][19][20][21][22]26,28,[35][36][37][38][39][40]42,43,45,48,49].…”