Kepler University Hospital, Linz, Austria; Johannes Kepler University, Linz, Austria.
Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia.
J Arthroplasty. 2022 Oct;37(10):2025-2034. doi: 10.1016/j.arth.2022.04.043. Epub 2022 May 5.
Loosening remains one of the most common reasons for revision total knee arthroplasty (TKA). Cement viscosity has a potential role in reducing revision rates for loosening. The aim of this study was to assess the outcome for loosening of the 5 most used cemented knee prostheses by constraint type, based on the cement viscosity type used.
There were 214,708 TKA procedures performed between 1999 and 2020 for a diagnosis of osteoarthritis using the 5 most commonly used minimally stabilized, posterior stabilized, and medial pivot design cemented tibial components. Only procedures with a cemented tibial component were included. Outcomes for two different cement viscosities, 140,060 high viscosity and 74,648 low viscosity cement, were compared for each fixation type within each of the three stability groups.
There was no difference in a risk of all-cause revision when high viscosity cement was used compared to low viscosity cement for minimally stabilized prostheses (hazards ratio [HR] 1.07 [95% CI 0.99-1.15], P = .09), posterior stabilized prostheses (HR 1.03 [95% CI 0.95-1.11], P = .53), and medial pivot design prostheses (HR 1.06 [95% CI 0.80-1.41], P = .67). No difference was observed between cement viscosity types for any of the prosthesis constraint types when aseptic loosening was assessed.
We found no difference in the risk of revision for any reason, or for loosening, with cement viscosity for the most commonly used minimally stabilized, posterior stabilized, and medial pivot TKA. The role of cement viscosity in the risk of TKA revision remains unclear and further research is required.
Level III Retrospective comparative study.
松动仍然是翻修全膝关节置换术（TKA）最常见的原因之一。水泥的粘性可能在降低松动的翻修率方面发挥作用。本研究旨在评估基于使用的水泥粘性类型，按约束类型评估 5 种最常用的骨水泥固定膝关节假体松动的结果。
1999 年至 2020 年间，共有 214708 例 TKA 手术因诊断为骨关节炎而使用 5 种最常用的最小稳定、后稳定和内侧枢轴设计骨水泥固定胫骨组件进行治疗。仅纳入使用骨水泥固定胫骨组件的手术。比较了每个稳定组内的 3 种稳定性中，每一种固定类型下两种不同水泥粘性（140060 高粘性和 74648 低粘性水泥）的结果。
与低粘性水泥相比，高粘性水泥在最小稳定假体（危险比 [HR] 1.07 [95%CI 0.99-1.15]，P=.09）、后稳定假体（HR 1.03 [95%CI 0.95-1.11]，P=.53）和内侧枢轴设计假体（HR 1.06 [95%CI 0.80-1.41]，P=.67）中，全因翻修的风险没有差异。在评估无菌性松动时，在任何假体约束类型之间都没有观察到水泥粘性类型之间的差异。
我们发现，在最常用的最小稳定、后稳定和内侧枢轴 TKA 中，水泥粘性在任何原因导致的翻修风险或松动风险方面没有差异。水泥粘性在 TKA 翻修风险中的作用仍不清楚，需要进一步研究。
三级回顾性比较研究。
