We have located links that may give you full text access.
JOURNAL ARTICLE
META-ANALYSIS
REVIEW
No difference in implant survivorship and clinical outcomes between full-cementless and full-cemented fixation in primary total knee arthroplasty: A systematic review and meta-analysis.
International Journal of Surgery 2018 May
BACKGROUND: The debate over the use of cemented or cementless fixation in total knee arthroplasty (TKA) has never stopped since cementless fixation was introduced. We undertook a systematic review and meta-analysis to evaluate the optimal mode of fixation (full-cementless vs. full-cemented) in TKA.
METHODS: PubMed, Embase, and the Cochrane Library databases up to July 2017 were searched to identify randomised controlled trials (RCTs) and quasi-RCTs comparing full-cementless TKA and full-cemented TKA. The primary outcome was implant survivorship. Secondary outcomes included radiological outcomes (maximum total point-motion [MTPM], radiolucent line, rotation degree) and clinical outcomes (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] score, Knee Society Score [KSS] score, postoperative range of movement, blood loss and complications).
RESULTS: Seven studies were included in the systematic review and meta-analysis. The mean follow-up was 7.1 years (range from 2 to 16.6 years). There was no difference in implant survivorship (RR, 0.98; 95% CI, 0.95-1.01; p = 0.25; I2 = 0%), MTPM (weighted mean difference [WMD], 0.13 mm; 95% CI, -0.69-0.95; p = 0.75; I2 = 89.3%) and radiolucent line (RR, 1.36; 95% CI, 0.57-3.23; p = 0.48; I2 = 54%) between the cementless and cemented methods. There was a mean 0.22° more rotation in the full-cementless fixation group (95% CI, 0.13-0.32; p < 0.01; I2 = 28.5%). There were no significant differences relating to clinical outcomes (WOMAC score, KSS score, postoperative range of movement, blood loss and complications) between the two fixation groups.
CONCLUSIONS: Although more overall component rotation is found in full-cementless fixation, the implant survivorship and clinical efficacy are likely similar between full-cementless and full-cemented fixation. However, future RCTs with similar cementless prosthetic coating and longer-term follow-up are still needed to confirm our findings.
METHODS: PubMed, Embase, and the Cochrane Library databases up to July 2017 were searched to identify randomised controlled trials (RCTs) and quasi-RCTs comparing full-cementless TKA and full-cemented TKA. The primary outcome was implant survivorship. Secondary outcomes included radiological outcomes (maximum total point-motion [MTPM], radiolucent line, rotation degree) and clinical outcomes (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] score, Knee Society Score [KSS] score, postoperative range of movement, blood loss and complications).
RESULTS: Seven studies were included in the systematic review and meta-analysis. The mean follow-up was 7.1 years (range from 2 to 16.6 years). There was no difference in implant survivorship (RR, 0.98; 95% CI, 0.95-1.01; p = 0.25; I2 = 0%), MTPM (weighted mean difference [WMD], 0.13 mm; 95% CI, -0.69-0.95; p = 0.75; I2 = 89.3%) and radiolucent line (RR, 1.36; 95% CI, 0.57-3.23; p = 0.48; I2 = 54%) between the cementless and cemented methods. There was a mean 0.22° more rotation in the full-cementless fixation group (95% CI, 0.13-0.32; p < 0.01; I2 = 28.5%). There were no significant differences relating to clinical outcomes (WOMAC score, KSS score, postoperative range of movement, blood loss and complications) between the two fixation groups.
CONCLUSIONS: Although more overall component rotation is found in full-cementless fixation, the implant survivorship and clinical efficacy are likely similar between full-cementless and full-cemented fixation. However, future RCTs with similar cementless prosthetic coating and longer-term follow-up are still needed to confirm our findings.
Full text links
Trending Papers
A Personalized Approach to the Management of Congestion in Acute Heart Failure.Heart International 2023
Potential Mechanisms of the Protective Effects of the Cardiometabolic Drugs Type-2 Sodium-Glucose Transporter Inhibitors and Glucagon-like Peptide-1 Receptor Agonists in Heart Failure.International Journal of Molecular Sciences 2024 Februrary 21
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app