Roth Sarah, DeClercq Madeleine Grace, Sacchetti Michael, Keeley Jacob, Karadsheh Mark, Runner Robert
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Oakland University William Beaumont School of Medicine, Rochester Hills, MI, USA.
Arthroplast Today. 2024 Sep 23;29:101499. doi: 10.1016/j.artd.2024.101499. eCollection 2024 Oct.
Cemented total knee arthroplasty (TKA) is the gold standard treatment for osteoarthritis, but uncemented TKA offers benefits like improved osseointegration and reduced complications from cement debris. This study aimed to investigate (1) if there has been a rise in uncemented TKA from 2017 to 2021 and (2) if there are differences in early complications between cemented and uncemented TKA.
A retrospective data review was performed on the Michigan Arthroplasty Registry Collaborative Quality Initiative database of TKA patients from 2017 to 2021 at 6 hospitals. Patients with revision or partial knee arthroplasty were excluded. Patients were divided into 2 groups: uncemented and cemented. Hybrid and reverse hybrid fixation data were collected for incidence, but not for demographics or complications. All patient demographics and 90-day postoperative events were collected and analyzed.
A retrospective study of 18,749 primary TKAs found that 89.7% were cemented, 9.7% uncemented, and 0.7% hybrid or reverse hybrid. Uncemented patients were younger, men, heavier, current smokers, and diabetics than cemented patients ( < .0001, = .03). They also had a shorter length of stay ( ≤ .0001) and were on fewer preoperative medications: anticoagulants ( = .0059), antiplatelets ( ≤ .0001), opioids ( = .0091), and steroids ( = .0039). The rate of uncemented TKA increased from 3.3% to 17.1%, while the rate of cemented TKA fell from 96.2% to 81.9% ( = .0048). The readmission rate was higher in cemented TKAs (4.0%) than in uncemented TKAs (2.6%) ( = .0048).
The use of uncemented TKA increased from 3.3% in 2017 to 17.1% in 2021, while cemented fixation decreased from 96.7% to 81.9%. There were no significant differences in short-term complications between groups. Uncemented patients were younger, men, took fewer medications, had a shorter length of stay, and were less likely to be readmitted. However, they were more likely to have comorbidities than the cemented group.
骨水泥型全膝关节置换术（TKA）是骨关节炎的金标准治疗方法，但非骨水泥型TKA具有一些优势，如改善骨整合和减少骨水泥碎屑引起的并发症。本研究旨在调查：（1）2017年至2021年非骨水泥型TKA的使用是否有所增加；（2）骨水泥型和非骨水泥型TKA早期并发症是否存在差异。
对密歇根关节置换登记协作质量改进计划数据库中2017年至2021年6家医院的TKA患者数据进行回顾性分析。排除翻修或部分膝关节置换患者。患者分为两组：非骨水泥型和骨水泥型。收集混合和反向混合固定的发病率数据，但不收集人口统计学或并发症数据。收集并分析所有患者的人口统计学资料和术后90天内的事件。
对18749例初次TKA的回顾性研究发现，89.7%为骨水泥型，9.7%为非骨水泥型，0.7%为混合或反向混合固定型。非骨水泥型患者比骨水泥型患者更年轻、男性居多、体重更重、当前吸烟者更多且患糖尿病者更多（P <.0001，P = 0.03）。他们的住院时间也更短（P≤.0001），术前使用的药物更少：抗凝剂（P = 0.0059）、抗血小板药物（P≤.0001）、阿片类药物（P = 0.0091）和类固醇（P = 0.0039）。非骨水泥型TKA的使用率从3.3%增至17.1%，而骨水泥型TKA的使用率从96.2%降至81.9%（P = 0.0048）。骨水泥型TKA的再入院率（4.0%）高于非骨水泥型TKA（2.6%）（P = 0.0048）。
非骨水泥型TKA的使用从2017年的3.3%增至2021年的17.1%，而骨水泥固定型从96.7%降至81.9%。两组短期并发症无显著差异。非骨水泥型患者更年轻、男性居多、用药更少、住院时间更短且再入院可能性更小。然而，他们比骨水泥型组更易合并其他疾病。
