Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2019

01-04-2019 | KNEE

Uncemented or cemented femoral components work equally well in total knee arthroplasty

Authors: Anders Henricson, Radek Wojtowicz, Kjell G. Nilsson, Sead Crnalic

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2019

Login to get access

Abstract

Purpose

To study the pattern of migration and clinical results up to 10 years of uncemented versus cemented fixation of the femoral component in total knee arthroplasty.

Methods

Randomized controlled trial was conducted of 41 patients (23 women, 18 men) under the age of 60 years using radiostereometric analysis.

Results

About two-thirds of the cemented implants and half of the uncemented implants stabilized between 2 and 10 years, while the remainder displayed a small annual increase of maximum total point motion of 0.09–0.10 mm/year. At 10 years there were no statistically significant differences in migration or clinical results between the groups.

Conclusion

Uncemented fixation with titanium fiber mesh coating of the femoral component in total knee arthroplasty works equally as well as cemented fixation up to 10 years. An annual migration of 0.1 mm seems compatible with excellent long-term performance.

Level of evidence

I.
Literature
1.
Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ (2009) Future young patient demand for primary and revision joint replacement. Clin Orthop Relat Res 467:2606–2612CrossRefPubMedPubMedCentral
2.
Leskinen J, Eskelinen A, Huhtala H, Paavolainen P, Remes V (2012) The incidence of knee arthroplasty for primary osteoarthritis grows rapidly among baby boomers: a population-based study in Finland. Arthritis Rheum 64:744–753CrossRef
3.
4.
Gie TJ, Novak C, Sinner P, Ma W, Mehle S (2007) Knee arthroplasty in the young patient: survival in a community register. Clin Orthop Relat Res 464:83–87
5.
Julin J, Jämsen E, Puolakka T, Konttinen Y, Moilanen T (2010) Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis: a follow-up study of 32,019 patients in the Finnish Arthroplasty Register. Acta Orthop 81:413–419CrossRefPubMedPubMedCentral
6.
Chockalingam S, Scott G (2000) The outcome of cemented vs cementless fixation of a femoral component in total knee replacement (TKR) with the identification of radiological signs for the prediction of failure. Knee 7:233–238CrossRefPubMed
7.
Khaw FM, Kirk LMG, Morris RW, Gregg PJ (2002) A randomized, controlled trial of cemented versus cementless press-fit condylar total knee replacement. Ten-year survival analysis. J Bone Jt Surg Br 84:658–666CrossRef
8.
Pulido L, Abdel MP, Lewallen DG, Stuart MJ, Sanchez-Sotelo J, Hansen AD, Pagnano MW (2015) Trabecular metal tibial component were durable and reliable in primary total knee arthroplasty: a randomized clinical trial. Clin Orthop Relat Res 473:34–42CrossRefPubMed
9.
Bozic KJ, Kurtz SM, Lau E, Ong K, Chiu V, Vail TP, Rubash HE, Berry DJ (2010) The epidemiology of revision total knee arthroplasty in the United States. Clin Orthop Relat Res 468:45–51CrossRefPubMed
10.
Mjöberg B (1986) Loosening of the cemented hip prosthesis. The importance of heat injury. Acta Orthop Scand 57(Suppl 221):3–40CrossRef
11.
Stürup J, Nimb L, Kramhøft M, Jensen JS (1994) Effect of polymerization heat and monomers from acrylic cement on canine bone. Acta Orthop Scand 65:20–33CrossRefPubMed
12.
Bos I, Fredebold D, Diebold J, Löhrs U (1995) Tissue reaction to cemented hip sockets. Histologic and morphometric autopsy study of 25 acetabula. Acta Orthop Scand 66:1–8CrossRefPubMed
13.
Kim Y-H, Choi Y, Kim J-S (2010) Osteolysis in well-functioning fixed- and mobile-bearing TKAs in younger patients. Clin Orthop Relat Res 468:3084–3093CrossRefPubMedPubMedCentral
14.
Henricson A, Nilsson KG (2016) Trabecular metal tibial component still stable at 10 years: an RSA study of 33 patients less than 60 years. Acta Orthop 87:504–510CrossRefPubMedPubMedCentral
15.
Nilsson KG, Henricson A, Norgren B, Dalén T (2006) Uncemented HA-coated implant is the optimum fixation for TKA in the young patient. Clin Orthop Relat Res 448:129–139CrossRefPubMed
16.
Dixon P, Parish EN, Cross MJ (2004) Arthroscopic debridement in the treatment of the infected total knee arthroplasty. J Bone Jt Surg Br 86:39–42CrossRef
17.
Gao F, Henricson A, Nilsson KG (2009) Cemented versus uncemented fixation of the femoral component of the NexGen CR total knee replacement in patients younger than 60 years: a prospective randomized controlled RSA study. Knee 16:200–206CrossRefPubMed
18.
Nilsson KG, Kärrholm J, Linder L (1995) Femoral component migration in total knee arthroplasty: randomized study comparing cemented and uncemented fixation of the Miller–Galante I design. J Orthop Res 13:347–356CrossRefPubMed
19.
Uvehammer J, Kärrholm J, Carlsson L (2007) Cemented versus hydroxyapatite fixation of the femoral component of the Freeman–Samuelson total knee replacement: a radiostereometric analysis. J Bone Jt Surg Br 89:39–44CrossRef
20.
21.
van Hamersveld KT, Marang-van de Mheen PJ, Tsonaka R, Valstar ER, Toksvig-Larsen S (2017) Fixation and clinical outcome of uncemented peri-apatite-coated cemented total knee arthroplasty. Five-year follow-up of a randomized controlled trial using radiostereometric analysis (RSA). Bone Jt J 99:1467–1476CrossRef
22.
van Hamersveld KT, Marang-van de Mheen PJ, van der Heide HJ, van der Linden-van der Zwaag HMJ, Valstar ER, Nelissen RGHH (2018) Migration and clinical outcome of mobile-bearing versus fixed-bearing single-radius total knee arthroplasty: a randomized controlled trial. Acta Orthop 89:190–196CrossRefPubMedPubMedCentral
23.
Henricson A, Rösmark D, Nilsson KG (2013) Trabecular metal tibial component still stable at 5 years: an RSA study of 36 patients less than 60 years. Acta Orthop 84:398–405CrossRefPubMedPubMedCentral
24.
Nilsson KG, Kärrholm J, Carlsson L, Dalén T (1999) Hydroxyapatite coating versus cemented fixation of the tibial component in total knee arthroplasty. Prospective randomized comparison of hydroxyapatite-coated and cemented tibial components with 5-year follow-up using radiostereometry. J Arthroplasty 14:9–20CrossRefPubMed
25.
Pijls BG, Valstar ER, Kaptein BL, Fiocco M, Nelissen RGGH (2012) The beneficial effect of hydroxyapatite lasts: a randomized radiostereometric trial comparing hydroxyapatite-coated, uncoated, and cemented tibial components for up to 16 years. Acta Orthop 83:135–141CrossRefPubMedPubMedCentral
26.
Vanlommel J, Luyckx JP, Labey L, Innocenti B, De Corte R, Bellemans J (2011) Cementing the tibial component in total knee arthroplasty: which technique is best? J Arthroplasty 26:492–496CrossRefPubMed
27.
Rahbek O, Kold S, Zippor B, Overgaard S, Søballe K (2005) The influence of surface porosity on gap-healing around intra-articular implants in presence of migrating particles. Biomaterials 26:4728–4736CrossRefPubMed
28.
Ranstam J, Ryd L, Önsten I (2000) Accurate accuracy measurement: review of basic principles. Acta Orthop Scand 71:106–108CrossRefPubMed
29.
Ewald F (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12
30.
Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14
31.
Pijls BG, Valstar ER, Nouta KA, Plevier JW, Fiocco M, Middeldorp S, Nelissen RGHH (2012) Early migration of tibial components is associated with late revision; a systemic review and meta-analysis of 21,000 knee arthroplasties. Acta Orthop 83:614–624CrossRefPubMedPubMedCentral
32.
Ryd L, Albrektsson BE, Carlsson L, Dansgard F, Herberts P, Lindstrand A, Regner L, Toksvig-Larsen S (1995) Roentgen stereophotogrammetric analysis as a predictor of mechanical loosening of knee prostheses. J Bone Jt Surg Br 77:377–383CrossRef
33.
Wilson DAJ, Richardson G, Hennigar AW, Dunbar MJ (2012) Continued stabilization of trabecular metal tibial monoblock total knee arthroplasty components at 5 years—measured with radiostereometric analysis. Acta Orthop 83:36–40CrossRefPubMedPubMedCentral
34.
Park JW, Kim YH (2011) Simultaneous cemented and cementless total knee replacement in the same patients: a prospective comparison of long term outcomes using an identical design of NexGen prosthesis. J Bone Jt Surg Br 93:1479–1486CrossRef
35.
Bouras T, Bitas V, Fennema P, Korovessis P (2017) Good long-term results following cementless TKA with a titanium plasma coating. Knee Surg Sports Traumatol Arthrosc 25:2801–2808CrossRefPubMed
36.
Demey G, Servien E, Lustig S, Selmi TAS, Neyret P (2011) Cemented versus uncemented femoral components in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19:1053–1059CrossRefPubMed
37.
Illgen R, Tueting J, Enright T, Schreibman K, McBeath A, Heiner J (2004) Hybrid total knee arthroplasty: a retrospective analysis of clinical and radiographic outcomes at average 10 years follow-up. J Arthroplasty 19:95–100CrossRefPubMed
38.
Kim Y-H, Park J-W, Lim H-M, Park E-S (2014) Cementless and cemented total knee arthroplasty in patients younger then fifty five years. Which is better? Int Orthop 38:297–303CrossRefPubMedPubMedCentral
39.
Ritter MA, Meneghini R (2010) Twenty-year survivorship of cementless Anatomic Graduated Component total knee arthroplasty. J Arthroplasty 25:507–513CrossRefPubMed
40.
Epinette J-A (2014) Long lasting outcome of hydroxyapatite-coated implants in primary knee arthroplasty: a continuous series of two hundred and seventy total knee athroplasties at fifteen to twenty years of clinical follow-up. Int Orthop 38:305–3011CrossRefPubMedPubMedCentral
Metadata
Title
Uncemented or cemented femoral components work equally well in total knee arthroplasty
Authors
Anders Henricson
Radek Wojtowicz
Kjell G. Nilsson
Sead Crnalic
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5227-5

Other articles of this Issue 4/2019

Knee Surgery, Sports Traumatology, Arthroscopy 4/2019 Go to the issue

Knee

Rotating hinge knee causes lower bone–implant interface stress compared to constrained condylar knee replacement

KNEE

Hybrid closed wedge high tibial osteotomy improves patellofemoral joint congruity compared with open wedge high tibial osteotomy

Correction

Correction to: Femoral insertion site of the graft used to replace the medial patellofemoral ligament influences the ligament dynamic changes during knee flexion and the clinical outcome

KNEE

Modern TKA implants are equivalent to traditional TKA implants in functional and patellofemoral joint-related outcomes

Knee

Patellofemoral design enhancements reduce long-term complications of postero-stabilized total knee arthroplasty

Knee

Vitamin C demand is increased after total knee arthroplasty: a double-blind placebo-controlled-randomized study