Mont Michael A, Pivec Robert, Issa Kimona, Kapadia Bhaveen H, Maheshwari Aditya, Harwin Steven F
Department of Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
Department of Orthopaedic Surgery, Seton Hall University of Health and Medical Sciences, Paterson, New Jersey.
J Knee Surg. 2014 Oct;27(5):369-76. doi: 10.1055/s-0033-1361952. Epub 2013 Dec 7.
Cementless total knee arthroplasty (TKA) has had limited use in the United States, however, recent reports have demonstrated promising results, but there has been no meta-analysis to examine these outcomes in the past 5 years. In this review, 37 studies (2,940 patients and 3,568 TKAs) were identified and used, comparing cementless to cemented TKA. Pooled implant survivorship was compared using a fixed-effect meta-analysis between cementless and cemented TKA, and between cementless TKA with and without screw fixation. Cementless TKA had implant survivorship comparable to cemented TKA (odds ratio, 1.1; 95% confidence interval [CI], 0.62-2.00). The mean survivorship at 10 years for cementless TKA was 95.6% compared with 95.3% for cemented TKA. At 20-year follow-up, implant survivorship decreased to 76 and 71%, respectively. No difference was observed between fixation with or without screws (OR, 1.1; 95% CI, 0.16-7.5). Implant survivorship for cementless TKA was comparable to the current gold standard cemented TKAs.
非骨水泥型全膝关节置换术（TKA）在美国的应用有限，然而，最近的报告显示了令人鼓舞的结果，但在过去5年中尚无荟萃分析来研究这些结果。在本综述中，共识别并使用了37项研究（2940例患者和3568例TKA），比较了非骨水泥型与骨水泥型TKA。采用固定效应荟萃分析比较了非骨水泥型与骨水泥型TKA之间以及有无螺钉固定的非骨水泥型TKA之间的植入物生存率。非骨水泥型TKA的植入物生存率与骨水泥型TKA相当（优势比，1.1；95%置信区间[CI]，0.62-2.00）。非骨水泥型TKA在10年时的平均生存率为95.6%，而骨水泥型TKA为95.3%。在20年随访时，植入物生存率分别降至76%和71%。有无螺钉固定之间未观察到差异（OR，1.1；95%CI，0.16-7.5）。非骨水泥型TKA的植入物生存率与当前的金标准骨水泥型TKA相当。
