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Published in: BMC Musculoskeletal Disorders 1/2024

Open Access 01-12-2024 | Systematic Review

A systematic review and meta-analysis of hybrid vs. cemented stems – which method is more optimal for revision total knee arthroplasty?

Authors: Yogen Thever, Sir Young James Loh, Raghuraman Raghavan, Rong Chuin Toh, Ing How Moo

Published in: BMC Musculoskeletal Disorders | Issue 1/2024

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Abstract

Introduction

The number of primary and revision Total Knee Arthroplasty (TKA) cases are expected to increase in future. There are various advantages and disadvantage to employing either of the two main types of stem fixation methods – cemented or hybrid technique. This review aimed to study the most optimal fixation method for revision TKAs by comparing radiological outcomes and re-revision rates.

Methods

A systematic review and meta-analysis was performed using PubMed and Cochrane Library from 2010 to identify studies explicitly comparing outcomes between cemented against hybrid fixation revision TKA techniques, with a minimum follow up of at least 24 months. A total of 8 studies was included in this review. Egger’s test and visual inspection of the funnel plot did not reveal publication bias.

Results

There was no statistically significant difference in radiological failure and loosening (OR 0.79, CI 0.37–1.66, I2 = 29%, p = 0.22), all causes of re-revision (OR 1.03, CI 0.73–1.44, I2 = 0%, p = 0.56) and aseptic revision (OR 0.74, CI 0.27–2.02, I2 = 0%, p = 0.41) between cemented and hybrid techniques. Functional and pain outcomes compared between the two fixation techniques were largely similar across the studies included in this meta-analysis.

Conclusion

Despite a trend favouring hybrid stems in revision TKA, current evidence revealed that radiological outcomes and re-revision rates are largely similar between cemented and hybrid fixation techniques.
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Metadata
Title
A systematic review and meta-analysis of hybrid vs. cemented stems – which method is more optimal for revision total knee arthroplasty?
Authors
Yogen Thever
Sir Young James Loh
Raghuraman Raghavan
Rong Chuin Toh
Ing How Moo
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2024
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-024-07389-y

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