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Cemented versus uncemented femoral components in total knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study is to analyse the influence of femoral cement on clinical and radiological results after total knee arthroplasty.

Methods

Preoperatively 130 patients were randomly assigned to treatment in either the Cement Group or the Hybrid Group. The International Knee Society scores, femoral radiolucent lines and bone transparencies were compared.

Results

There were no significant differences concerning postoperative knee and function scores. We observed a significant difference in radiolucent lines (Cement Group, 24%; Hybrid Group, 2%; P < 0.001) as well as bone transparencies (Cement Group, 21%; Hybrid Group, 62%; P < 0.001). All radiolucent lines measured less than 2 mm in width.

Conclusion

Cementing the femoral component of a total knee arthroplasty does not appear to influence the clinical results. A longer follow-up period is required to determine the influence of radiological findings on final outcome.

Level of evidence

I.

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References

  1. Ahlback S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) 277:7–72

    Google Scholar 

  2. Akizuki S, Takizawa T, Horiuchi H (2003) Fixation of a hydroxyapatite-tricalcium phosphate-coated cementless knee prosthesis. Clinical and radiographic evaluation seven years after surgery. J Bone Joint Surg Br 85:1123–1127

    Article  PubMed  CAS  Google Scholar 

  3. Berger RA, Rosenberg AG, Barden RM, Sheinkop MB, Jacobs JJ, Galante JO (2001) Long-term follow-up of the Miller-Galante total knee replacement. Clin Orthop Relat Res 388:58–67

    Article  PubMed  Google Scholar 

  4. Campbell MD, Duffy GP, Trousdale RT (1998) Femoral component failure in hybrid total knee arthroplasty. Clin Orthop Relat Res 356:58–65

    Article  PubMed  Google Scholar 

  5. Carlsson A, Bjorkman A, Besjakov J, Onsten I (2005) Cemented tibial component fixation performs better than cementless fixation: a randomized radiostereometric study comparing porous-coated, hydroxyapatite-coated and cemented tibial components over 5 years. Acta Orthop 76:362–369

    Article  PubMed  Google Scholar 

  6. Chambers B, St Clair SF, Froimson MI (2007) Hydroxyapatite-coated tapered cementless femoral components in total hip arthroplasty. J Arthroplasty 22:71–74

    Article  PubMed  Google Scholar 

  7. 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 7:233–238

    Article  PubMed  Google Scholar 

  8. Dixon MC, Brown RR, Parsch D, Scott RD (2005) Modular fixed-bearing total knee arthroplasty with retention of the posterior cruciate ligament. A study of patients followed for a minimum of fifteen years. J Bone Joint Surg Am 87:598–603

    Article  PubMed  Google Scholar 

  9. Duffy GP, Berry DJ, Rand JA (1998) Cement versus cementless fixation in total knee arthroplasty. Clin Orthop Relat Res 356:66–72

    Article  PubMed  Google Scholar 

  10. Ewald FC (1989) The knee society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12

    PubMed  Google Scholar 

  11. Font-Rodriguez DE, Scuderi GR, Insall JN (1997) Survivorship of cemented total knee arthroplasty. Clin Orthop Relat Res 345:79–86

    Article  PubMed  Google Scholar 

  12. 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 randomised controlled RSA study. Knee 16:200–206

    Article  PubMed  Google Scholar 

  13. Gill GS, Joshi AB (2001) Long-term results of Kinematic Condylar knee replacement. An analysis of 404 knees. J Bone Joint Surg Br 83:355–358

    Article  PubMed  CAS  Google Scholar 

  14. Hartford JM, Hunt T, Kaufer H (2001) Low contact stress mobile bearing total knee arthroplasty: results at 5 to 13 years. J Arthroplasty 16:977–983

    Article  PubMed  CAS  Google Scholar 

  15. Hofmann AA, Evanich JD, Ferguson RP, Camargo MP (2001) Ten- to 14-year clinical follow-up of the cementless natural knee system. Clin Orthop Relat Res 388:85–94

    Article  PubMed  Google Scholar 

  16. Huddleston JI, Wiley JW, Scott RD (2005) Zone 4 femoral radiolucent lines in hybrid versus cemented total knee arthroplasties: are they clinically significant? Clin Orthop Relat Res 441:334–339

    Article  PubMed  Google Scholar 

  17. 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 19:95–100

    Article  PubMed  Google Scholar 

  18. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  19. Insall JN, Ranawat CS, Scott WN, Walker P (1976) Total condylar knee replacement: preliminary report. Clin Orthop Relat Res 120:149–154

    PubMed  Google Scholar 

  20. Laskin RS (2001) The genesis total knee prosthesis: a 10-year follow-up study. Clin Orthop Relat Res 388:95–102

    Article  PubMed  Google Scholar 

  21. Liu TK, Yang RS, Chieng PU, Shee BW (1995) Periprosthetic bone mineral density of the distal femur after total knee arthroplasty. Int Orthop 19:346–351

    Article  PubMed  CAS  Google Scholar 

  22. Nilsson KG, Karrholm 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 13:347–356

    Article  PubMed  CAS  Google Scholar 

  23. Parker DA, Rorabeck CH, Bourne RB (2001) Long-term follow-up of cementless versus hybrid fixation for total knee arthroplasty. Clin Orthop Relat Res 388:68–76

    Article  PubMed  Google Scholar 

  24. Peters PC, Engh GA, Dwyer KA, Vinh TN (1992) Osteolysis after total knee arthroplasty without cement. J Bone Joint Surg Am 74:864–876

    PubMed  Google Scholar 

  25. Petersen MM, Nielsen PT, Lauritzen JB, Lund B (1995) Changes in bone mineral density of the proximal tibia after uncemented total knee arthroplasty. A 3-year follow-up of 25 knees. Acta Orthop Scand 66:513–516

    Article  PubMed  CAS  Google Scholar 

  26. Ritter MA, Meneghini RM (2010) Twenty-year survivorship of cementless anatomic graduated component total knee arthroplasty. J Arthroplasty 25:507–513

    Article  PubMed  Google Scholar 

  27. Rorabeck CH (1999) Total knee replacement: should it be cemented or hybrid? Can J Surg 42:21–26

    PubMed  CAS  Google Scholar 

  28. Tayot O, Aït Si Selmi T, Neyret P (2001) Results at 11.5 years of a series of 376 posterior stabilized HLS1 total knee replacements. Survivorship analysis, and risk factors for failure. Knee 8:195–205

    Article  PubMed  CAS  Google Scholar 

  29. Uvehammer J, Karrholm J, Carlsson L (2007) Cemented versus hydroxyapatite fixation of the femoral component of the Freeman-Samuelson total knee replacement: a radiostereometric analysis. J Bone Joint Surg Br 89:39–44

    PubMed  CAS  Google Scholar 

  30. Van Rietbergen B, Huiskes R, Weinans H, Sumner DR, Turner TM, Galante JO (1993) ESB Research Award 1992. The mechanism of bone remodeling and resorption around press-fitted THA stems. J Biomech 26:369–382

    Article  PubMed  Google Scholar 

  31. Watanabe H, Akizuki S, Takizawa T (2004) Survival analysis of a cementless, cruciate-retaining total knee arthroplasty. Clinical and radiographic assessment 10 to 13 years after surgery. J Bone Joint Surg Br 86:824–829

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank Camdon Fary, M.D., Jean-Christian Balestro, M.D. and Patrice Adeleine, M.D. for their assistance in preparation of the manuscript. There was no external funding source for the study.

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Authors and Affiliations

  1. Centre Albert Trillat, Hôpital de la Croix-Rousse, 103 Grande rue de la Croix Rousse, 69004, Lyon, France

    Guillaume Demey, Elvire Servien, Sebastien Lustig, Tarik Aït Si Selmi & Philippe Neyret

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  1. Guillaume Demey
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  2. Elvire Servien
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  3. Sebastien Lustig
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  4. Tarik Aït Si Selmi
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  5. Philippe Neyret
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Correspondence to Guillaume Demey.

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Demey, G., Servien, E., Lustig, S. et al. Cemented versus uncemented femoral components in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19, 1053–1059 (2011). https://doi.org/10.1007/s00167-010-1347-2

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  • DOI: https://doi.org/10.1007/s00167-010-1347-2

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