Wilczyński Mikołaj, Bieniek Michał, Krakowski Przemysław, Karpiński Robert
Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland.
Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, Staszica 11, 20-081 Lublin, Poland.
Materials (Basel). 2024 Feb 29;17(5):1136. doi: 10.3390/ma17051136.
Knee osteoarthritis (OA) is one of the leading causes of disability around the globe. Osteoarthritis is mainly considered a disease affecting the elderly. However, more and more studies show that sports overuse, obesity, or congenital disorders can initiate a pathologic cascade that leads to OA changes in the younger population. Nevertheless, OA mostly affects the elderly, and with increasing life expectancy, the disease will develop in more and more individuals. To date, the golden standard in the treatment of the end-stage of the disease is total joint replacement (TJR), which restores painless knee motion and function. One of the weakest elements in TJR is its bonding with the bone, which can be achieved by bonding material, such as poly methyl-methacrylate (PMMA), or by cementless fixation supported by bone ingrowth onto the endoprosthesis surface. Each technique has its advantages; however, the most important factor is the revision rate and survivor time. In the past, numerous articles were published regarding TJR revision rate, but no consensus has been established yet. In this review, we focused on a comparison of cemented and cementless total knee replacement surgeries. We introduced PICO rules, including population, intervention, comparison and outcomes of TJR in a PubMed search. We identified 783 articles published between 2010 and 2023, out of which we included 14 in our review. Our review reveals that there is no universally prescribed approach to fixate knee prostheses. The determination of the most suitable method necessitates an individualized decision-making process involving the active participation and informed consent of each patient.
膝关节骨关节炎（OA）是全球致残的主要原因之一。骨关节炎主要被认为是一种影响老年人的疾病。然而，越来越多的研究表明，运动过度、肥胖或先天性疾病可引发一系列病理过程，导致年轻人群出现OA病变。尽管如此，OA主要影响老年人，随着预期寿命的增加，该疾病将在越来越多的个体中发展。迄今为止，该疾病终末期治疗的金标准是全关节置换术（TJR），它能恢复无痛的膝关节活动和功能。TJR中最薄弱的环节之一是其与骨骼的结合，这可以通过粘结材料（如聚甲基丙烯酸甲酯（PMMA））来实现，或者通过骨长入假体表面来实现非骨水泥固定。每种技术都有其优点；然而，最重要的因素是翻修率和假体使用寿命。过去，发表了许多关于TJR翻修率的文章，但尚未达成共识。在本综述中，我们重点比较了骨水泥型和非骨水泥型全膝关节置换手术。我们在PubMed搜索中引入了PICO规则，包括TJR的人群、干预措施、对照和结局。我们确定了2010年至2023年间发表的783篇文章，其中14篇纳入了我们的综述。我们的综述表明，对于固定膝关节假体，没有普遍适用的方法。确定最合适的方法需要一个个体化的决策过程，包括每个患者的积极参与和知情同意。
