Ophélie Manchec, Emilie Bérard, Regis Pailhé, Sébastien Lustig, Etienne Cavaignac
{"title":"在5266例使用深盘移动轴承植入物的患者中，骨水泥与无骨水泥全膝关节置换术的5年生存率无差异。","authors":"Ophélie Manchec, Emilie Bérard, Regis Pailhé, Sébastien Lustig, Etienne Cavaignac","doi":"10.1002/ksa.12668","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The best fixation method for total knee arthroplasty (TKA) remains controversial. The aim of this study is to compare the effect of cemented and cementless fixation on prosthesis survivorship. Our primary hypothesis is that there is no difference in survivorship between cemented and cementless TKA. Our secondary hypothesis is that there is no difference in aseptic revisions and functional outcomes between cemented and cementless TKA at mid-term follow-up.</p><p><strong>Methods: </strong>A multicentre retrospective study was done using data collected prospectively in a large cohort. The same deep-dish mobile bearing design was used for both cemented and cementless TKA. Patients were divided into two groups according to the fixation method. The survival rate between cemented and cementless TKA was compared. Functional outcomes were collected preoperatively and at the 5-year follow-up.</p><p><strong>Results: </strong>Of the 5266 primary TKA included, 4549 were cementless, and 717 were cemented. At 5 years, there was no significant difference between the survivorship of the cementless (98.7% [95% confidence interval, CI: 98.2-99.1]) and cemented TKA (97.6%, [95% CI: 94.1-99.1]) (p = 0.468). There was no significant difference in the surgery-free survival at 5 years between cementless (95.8% [95% CI: 94.9-96.5]) and cemented TKA (95.5% [95% CI: 92.1-97.5]) (p = 0.508) as well as in aseptic revision: cementless (96.9% [95% CI: 96.2-97.5]) and cemented TKA (97.5 [95% CI: 95.5-98.6]) (p = 0.355). There was no significant difference in the functional outcomes at 5 years.</p><p><strong>Conclusion: </strong>There was no observed difference in survivorship between cemented and cementless TKA at 5 years in this cohort of 5266 patients. Additionally, rates of reoperation and aseptic revision were similar across both fixation methods, and clinical outcomes did not differ significantly. Therefore, it may be suggested that cementless fixation is a safe option for primary TKA.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"No difference in 5-year survivorship between cemented versus cementless total knee arthroplasty in a cohort of 5266 patients using a deep-dish mobile bearing implant.\",\"authors\":\"Ophélie Manchec, Emilie Bérard, Regis Pailhé, Sébastien Lustig, Etienne Cavaignac\",\"doi\":\"10.1002/ksa.12668\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The best fixation method for total knee arthroplasty (TKA) remains controversial. The aim of this study is to compare the effect of cemented and cementless fixation on prosthesis survivorship. Our primary hypothesis is that there is no difference in survivorship between cemented and cementless TKA. Our secondary hypothesis is that there is no difference in aseptic revisions and functional outcomes between cemented and cementless TKA at mid-term follow-up.</p><p><strong>Methods: </strong>A multicentre retrospective study was done using data collected prospectively in a large cohort. The same deep-dish mobile bearing design was used for both cemented and cementless TKA. Patients were divided into two groups according to the fixation method. The survival rate between cemented and cementless TKA was compared. Functional outcomes were collected preoperatively and at the 5-year follow-up.</p><p><strong>Results: </strong>Of the 5266 primary TKA included, 4549 were cementless, and 717 were cemented. At 5 years, there was no significant difference between the survivorship of the cementless (98.7% [95% confidence interval, CI: 98.2-99.1]) and cemented TKA (97.6%, [95% CI: 94.1-99.1]) (p = 0.468). There was no significant difference in the surgery-free survival at 5 years between cementless (95.8% [95% CI: 94.9-96.5]) and cemented TKA (95.5% [95% CI: 92.1-97.5]) (p = 0.508) as well as in aseptic revision: cementless (96.9% [95% CI: 96.2-97.5]) and cemented TKA (97.5 [95% CI: 95.5-98.6]) (p = 0.355). There was no significant difference in the functional outcomes at 5 years.</p><p><strong>Conclusion: </strong>There was no observed difference in survivorship between cemented and cementless TKA at 5 years in this cohort of 5266 patients. Additionally, rates of reoperation and aseptic revision were similar across both fixation methods, and clinical outcomes did not differ significantly. Therefore, it may be suggested that cementless fixation is a safe option for primary TKA.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-04-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12668\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12668","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
No difference in 5-year survivorship between cemented versus cementless total knee arthroplasty in a cohort of 5266 patients using a deep-dish mobile bearing implant.
Purpose: The best fixation method for total knee arthroplasty (TKA) remains controversial. The aim of this study is to compare the effect of cemented and cementless fixation on prosthesis survivorship. Our primary hypothesis is that there is no difference in survivorship between cemented and cementless TKA. Our secondary hypothesis is that there is no difference in aseptic revisions and functional outcomes between cemented and cementless TKA at mid-term follow-up.
Methods: A multicentre retrospective study was done using data collected prospectively in a large cohort. The same deep-dish mobile bearing design was used for both cemented and cementless TKA. Patients were divided into two groups according to the fixation method. The survival rate between cemented and cementless TKA was compared. Functional outcomes were collected preoperatively and at the 5-year follow-up.
Results: Of the 5266 primary TKA included, 4549 were cementless, and 717 were cemented. At 5 years, there was no significant difference between the survivorship of the cementless (98.7% [95% confidence interval, CI: 98.2-99.1]) and cemented TKA (97.6%, [95% CI: 94.1-99.1]) (p = 0.468). There was no significant difference in the surgery-free survival at 5 years between cementless (95.8% [95% CI: 94.9-96.5]) and cemented TKA (95.5% [95% CI: 92.1-97.5]) (p = 0.508) as well as in aseptic revision: cementless (96.9% [95% CI: 96.2-97.5]) and cemented TKA (97.5 [95% CI: 95.5-98.6]) (p = 0.355). There was no significant difference in the functional outcomes at 5 years.
Conclusion: There was no observed difference in survivorship between cemented and cementless TKA at 5 years in this cohort of 5266 patients. Additionally, rates of reoperation and aseptic revision were similar across both fixation methods, and clinical outcomes did not differ significantly. Therefore, it may be suggested that cementless fixation is a safe option for primary TKA.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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