Long-term effects of cemented and cementless fixations of total knee arthroplasty: a meta-analysis and systematic review of randomized controlled trials
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(23):6 J Orthop Surg Res. 2021 Oct 12;16(1): 590.What this means for my practice?
Results of this study suggest that cemented and cementless fixation provide similar long-term survival, clinical outcomes, and range of motion. However, cementless fixation may result in a lower rate of radiolucent lines, whilst cemented fixation may result in less maximal total point motion, which is a predictor of implant loosening. This study was limited by the use of hybrid fixation (not fully cemented or cementless) in half of the studies, as well as the non-reporting of patient blinding or outcome assessor blinding.
Study Summary
Eight randomized controlled trials with a total of 1,123 patients undergoing a primary total knee arthroplasty for osteoarthritis or rheumatoid arthritis were included in this meta-analysis comparing cemented and cementless fixation. Outcomes of interest included implant survival, Knee Society knee, function, and pain scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion, incidence of radiolucent lines, and maximum total point motion. Included studies had a minimum follow-up of 8.8 years. Meta-analysis results revealed no significant difference between the two groups in implant survival, clinical scores, or range of motion. However, the incidence of radiolucent lines was significantly lower in the cementless group, whilst maximum total point motion was significantly lower in the cemented group.
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