The Center for Hip and Knee Surgery, Mooresville, Indiana.
J Arthroplasty. 2023 Jun;38(6S):S151-S156. doi: 10.1016/j.arth.2023.03.043. Epub 2023 Mar 23.
With the use of newer biomaterials, many authors have reported similar results between cementless and cemented total knee arthroplasty (TKA). The purpose of this study was to compare the early clinical and radiographic outcomes of cementless and cemented TKA using the same dual-pivot articulation.
A consecutive series of 806 TKAs were implanted by a single surgeon using the same dual-pivot articulation. There were 634 TKAs (79%) cemented and 172 (21%) uncemented. One patient in the cementless group was lost before two years. The remaining 171 cementless TKAs were matched 1:1 with cemented TKAs with respect to age, sex, and body mass index. All patients were followed for a minimum of two years (range, 24-66 months) using the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement , and Knee Society clinical and radiographic evaluation. The average follow-up was 3.8 years (range, 24-66 months) in the cemented group and 3.4 years (range, 24-56 months) in the cementless group.
At final follow-up, the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement was higher in the cementless group (86 points (range, 64-100) versus 80 points (range, 57-100). Postoperative Knee Society scores (including pain and function) were similar. There was one deep infection (cemented TKA). The manipulation rate was 1.2% in the cementless group and 2.4% in the cemented TKA group. Excluding infection, two knees (1.2%) were revised in each group. No cases of femoral or tibial component loosening were identified.
Patients implanted with either a cemented or cementless TKA using the same conforming dual-pivot articulation design had similar early outcomes and functional improvements. The type of fixation did not appear to influence the early clinical results.
随着新型生物材料的应用，许多作者报告称，非骨水泥固定与骨水泥固定全膝关节置换术（TKA）之间的结果相似。本研究的目的是比较使用相同双枢轴关节的非骨水泥固定与骨水泥固定 TKA 的早期临床和影像学结果。
一位外科医生连续为 806 例 TKA 患者植入假体，均使用相同的双枢轴关节。其中 634 例（79%）采用骨水泥固定，172 例（21%）采用非骨水泥固定。非骨水泥组中有 1 例患者在随访 2 年内失访。其余 171 例非骨水泥 TKA 与骨水泥 TKA 按照年龄、性别和体重指数进行 1:1 配对。所有患者均采用膝关节损伤和骨关节炎结果评分（KOOS）和膝关节学会临床和影像学评估进行至少 2 年（24-66 个月）的随访。骨水泥组的平均随访时间为 3.8 年（24-66 个月），非骨水泥组为 3.4 年（24-56 个月）。
在最终随访时，非骨水泥组的 KOOS 评分（86 分（范围，64-100））高于骨水泥组（80 分（范围，57-100））。术后膝关节学会评分（包括疼痛和功能）相似。骨水泥组发生 1 例深部感染（TKA），非骨水泥组的翻修率为 1.2%，骨水泥组为 2.4%。排除感染后，每组各有 2 例（1.2%）膝关节需要翻修。未发现股骨或胫骨组件松动的病例。
使用相同的顺应性双枢轴关节设计，植入骨水泥固定或非骨水泥固定 TKA 的患者具有相似的早期结果和功能改善。固定类型似乎不会影响早期临床结果。
