Prudhon Jean-Louis, Verdier Régis
Centre ostéo-articulaire, 5 rue Raoul Blanchard, 38000 Grenoble, France.
Groupe Lépine, 175 rue Jacquard, CS 50307, 69727 Genay Cedex, France.
SICOT J. 2017;3:70. doi: 10.1051/sicotj/2017046. Epub 2017 Dec 12.
Since 1996 we have been using cementless fixation with hydroxyapatite (HA) coating. The purpose of this paper is to compare survivorship of a series of 100 cemented Total Knee Arthroplasty (TKA) to a similar series of 100 cementless with a follow up of 11-16 years. Material methods: Both TKA are mobile bearing total knee postero-stabilized. They can be used with cement or without cement. Among 1030 New Wave TKATM implanted from 2002 to 2015 we have identified 100 cemented TKAs and 100 cementless TKAs. All these cases were primary replacement. Differences in survival probability were determined using log-rank test.
Survival probabilities at 11 years of follow-up were: Cemented group: 90.2% CI95% [81.9-94.8]; Cementless group: 95.4% CI95% [88.1-98.2]. Comparison between both group showed significant difference, p = 0.32.
The advantages of cementless TKA are bone stock preservation, cement debris protection and the potential to achieve biologic fixation. Cementless implants rely on a porous or roughened surface to facilitate bone formation. HA has been shown to accelerate bone integration and to decrease micro motion of the components and to increase fixation. With a survival probability of 90.2% (cemented version) and 95.4% (cementless version), this total knee prosthesis performs as intended in primary total knee arthroplasty. No statistical differences could be found between cemented and cementless implants.
自1996年以来，我们一直在使用羟基磷灰石（HA）涂层的非骨水泥固定方法。本文的目的是比较100例骨水泥型全膝关节置换术（TKA）与100例类似的非骨水泥型全膝关节置换术的生存率，随访时间为11至16年。材料方法：两种TKA均为活动平台后稳定型全膝关节。它们既可以使用骨水泥，也可以不使用骨水泥。在2002年至2015年植入的1030例New Wave TKATM中，我们确定了100例骨水泥型TKA和100例非骨水泥型TKA。所有这些病例均为初次置换。使用对数秩检验确定生存概率的差异。
随访11年时的生存概率为：骨水泥组：90.2%，95%置信区间[81.9 - 94.8]；非骨水泥组：95.4%，95%置信区间[88.1 - 98.2]。两组之间的比较显示出显著差异，p = 0.32。
非骨水泥型TKA的优点是保留骨量、保护骨水泥碎片以及实现生物固定的潜力。非骨水泥植入物依靠多孔或粗糙的表面来促进骨形成。HA已被证明可加速骨整合、减少组件的微动并增加固定。这种全膝关节假体在初次全膝关节置换术中按预期发挥作用，骨水泥型和非骨水泥型植入物的生存率分别为90.2%（骨水泥型）和95.4%（非骨水泥型）。在骨水泥型和非骨水泥型植入物之间未发现统计学差异。
