Survivorship analysis of cemented total condylar knee arthroplasty

Nafei, Adel; Kristensen, Ole; Knudsen, Harald; Hvid, Ivan; Jensen, John

doi:10.1016/s0883-5403(96)80155-0

Cited by 58 publications

(29 citation statements)

References 16 publications

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“…Hence, we feel it is important to record survival analysis for this separately. The 10-year survival rate of 97.04% is as good as most published data [2,9,[17][18][19].…”

Section: Discussionsupporting

confidence: 70%

“…Hence, it has advantages over product limit methods such as Kaplan-Meier [1,8,10,15,16]. The 10-year survival for total knee arthroplasty, using revision surgery as an endpoint, is over 92% for a number of well-established prostheses [2,3,11,17,19]. With the PFC system, using revision surgery as an endpoint, Schai reports 90% 10-year survival; Khaw reports 95.5% 10-year survival, and also 95.3% and 95.6% for cemented and cementless fixation respectively at 10 years.…”

Section: Discussionmentioning

confidence: 99%

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Ten-year survival analysis of the PFC total knee arthroplasty-a surgeon’s first 99 replacements

Santini

Raut

2007

International Orthopaedics (SICO

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Ninety-seven patients with 99 total knee arthroplasties were operated on by a surgeon in the first 3 years of his surgical career. Complete survival data were available for all 99 knees. The cases were reviewed at a minimum of 10 years after their initial operation, but as 37 patients had died before reaching 10 years, the average follow-up was 8 years 8 months with a maximum of 12 years 4 months. Ninety-one patients had osteoarthritis, five had rheumatoid arthritis, and three had juvenile chronic arthritis. No patients were lost to follow-up. Four required revision. The 10-year survival rate, using revision for all causes as an end-point, was 94.96%. The survival rate for aseptic loosening was 97.04%. The survival rate for loose joints that had not been revised was 94.13%. Three of the four revisions occurred in the first 6 patients operated upon, suggesting there may be a learning curve for surgeons at this stage in their career.Résumé Quatre-vingt-dix-sept patients ayant bénéficié de 99 prothèses totales du genou mises en place par un seul chirurgien lors de ces trois premières années d'activité. Toutes les données ont été récoltées pour ces 99 genoux. Ces patients ont été revus avec un minimum de 10 ans après l'intervention. Trente-sept étaient décédés. Le suivi moyen était de 8 ans 8 mois avec un maximum de 12 ans 4 mois. Quarante-vingt-onze patients avaient été traités pour arthrose, 5 pour arthrite rhumatoïde et 3 pour arthrite rhumatoïde juvénile, maladie de Still-Chauffard. Aucun patient n'a été perdu de vue. Quatre ont nécessité une reprise chirurgicale. Le taux de révision à 10 ans en prenant comme contrôle la révision quelle que soit la cause a été de 94.96%, le taux de survie pour descellement aseptique de 97.04%. Le taux de survie pour les patients qui n'ont pas été repris a été de 94.13%. Trois des quatre révisions sont survenues chez les six premiers patients opérés par le chirurgien et faisaient partie de la courbe d'apprentissage.

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“…Hence, we feel it is important to record survival analysis for this separately. The 10-year survival rate of 97.04% is as good as most published data [2,9,[17][18][19].…”

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Ten-year survival analysis of the PFC total knee arthroplasty-a surgeon’s first 99 replacements

Santini

Raut

2007

International Orthopaedics (SICO

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“…In these reports either clinical assessment is collected and not reported, 22 postoperative scores are reported but not compared with preoperative scores, 14,17,23 or only preoperative scores are included. 13,16 The number of implants with clinical assessment at ten years in our series is only 16% of the original cohort and therefore represents only a minor indication of the clinical outcome. We plan to continue to review these patients for a larger sample for clinical outcome at ten years.…”

Section: Discussionmentioning

confidence: 91%

“…Many survival analyses of TKR include a number of patients lost to follow-up ranging from 3% to 13% of the initial cohort. [13][14][15][16][17] The reported cumulative survival rates in these series may be an overestimation of the true survival rate. 21 Implant survival data for patients who have died are often not included and some of these prostheses may have been revised before death.…”

Section: Discussionmentioning

confidence: 99%

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A randomised, controlled trial of cemented versus cementless press-fit condylar total knee replacement

Khaw

Kirk

Morris

et al. 2002

The Journal of Bone and Joint Surgery. British volume

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We have carried out a long-term survival analysis of a prospective, randomised trial comparing cemented with cementless fixation of press-fit condylar primary total knee replacements. A consecutive series of 501 replacements received either cemented (219 patients, 277 implants) or cementless (177 patients, 224 implants) fixation.The patients were contacted at a mean follow-up of 7.4 years (2.7 to 13.0) to establish the rate of survival of the implant. The ten-year survival was compared using life-table and Cox's proportional hazard analysis.No patient was lost to follow-up. The survival at ten years was 95.3% (95% CI 90.3 to 97.8) and 95.6% (95% CI 89.5 to 98.2) in the cemented and cementless groups, respectively. The hazard ratio for failure in cemented compared with cementless prostheses was 0.97 (95% CI 0.36 to 2.6). A comparison of the clinical outcome at ten years in 80 knees showed no difference between the two groups.The survival of the press-fit condylar total knee replacement at ten years is good irrespective of the method of fixation and brings into question the use of more expensive cementless implants. J Bone Joint Surg [Br] 2002;84-B:658-66. Received 27 July 2001; Accepted 24 September 2001 As the demand for knee replacement surgery increases resources need to be allocated to implants with the best long-term clinical outcome and survival rates.Liow and Murray 1 reported that 54% of knee prostheses, which were available in the UK did not have functional or survival results published in peer-reviewed journals. In their report, there were only five implants (13%) with published survival analyses of ten years or more and only five (13%) for which a functional outcome at more than five years was available. This paucity of data concerning the long-term outcome after total knee replacement (TKR) is alarming considering the rapid rise in the number of different designs of prostheses which are available. There is considerable debate regarding the possible benefits of using cementless fixation in joint replacement surgery. These include preservation of bone stock, ease of revision, the avoidance of complications of cementation and lastly, but most importantly, improved long-term survival of the implant. Although it is now clear that aseptic loosening is mainly related to wear debris rather than to cemented fixation, the question remains as to whether cementless implants have an improved long-term survival. This can only be answered by a randomised trial comparing the two methods of fixation. For TKR no such reports have been published in peer-reviewed journals. Our aim therefore was to compare the long-term survival, in a prospective randomised trial, of cemented with cementless fixation, using the press-fit condylar TKR system.

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Properties of acrylic bone cement: State of the art review

Lewis¹

1997

J. Biomed. Mater. Res.

674

465

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Acrylic bone cement occupies a distinctive place in the hierarchy of synthetic biomaterials, because it is the only material currently used for anchoring the prosthesis to the contiguous bone in a cemented arthroplasty. However, the cement is not without its drawbacks. The main one is the role that it has been postulated to play in the aseptic loosening and, hence, clinical life of the arthroplasty. In turn, this role is directly related to the mechanical properties of the cement, especially the resistance to fracture of the cement in the mantle at the cement-prosthesis interface or the cement-bone interface. The present work is a detailed critical review of the recent literature on the properties of bone cement that are considered germane to its use in the stated application. The relevant properties are identified and a case is made for including each of them. Compilations of the values of these properties, obtained under clearly identified conditions, are presented for the six commercial formulations of bone cement in current popular orthopedic use. The gaps and unresolved questions in the current data base, efforts that should be made to address these issues, and research directions are covered.

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Survivorship analysis of cemented total condylar knee arthroplasty

Cited by 58 publications

References 16 publications

Ten-year survival analysis of the PFC total knee arthroplasty-a surgeon’s first 99 replacements

Ten-year survival analysis of the PFC total knee arthroplasty-a surgeon’s first 99 replacements

A randomised, controlled trial of cemented versus cementless press-fit condylar total knee replacement

Properties of acrylic bone cement: State of the art review

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