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Modern cementless posterior stabilized mobile-bearing total knee arthroplasty shows comparable clinical and radiographical results to its cemented predecessor at 1-year follow-up

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate perioperative and short-term clinical and radiographical results of a modern PS mobile-bearing cementless TKA system.

Methods

A retrospective review of a consecutive series of TKAs was performed by a single surgeon using a cementless or cemented TKA of the same design (Attune, DePuy Synthes, Massachusetts, USA). The 2011 Knee Society Score, Forgotten Joint Score-12, Hip-Knee-Ankle angle, and the presence of radiolucent lines (RLLs) were reviewed 1-year postoperatively with 1:1 matching performed for age, gender, body mass index, and preoperative UCLA score. Fisher’s exact test or independent Student’s t-test were used for statistical analyses.

Results

Forty-five cementless and 45 cemented TKAs were reviewed after 1:1 matching. The mean operative time was 8.8 min shorter (P < .01), and the mean amount of drainage was 40.0 ml greater (P = .04) in the cementless cohort. At 1-year postoperatively, there were no significant differences in both cohorts in 2011 Knee Scores and Forgotten Joint Scores-12, with no patients requiring revision surgery (NS). The incidence of RLLs was significantly higher in cementless TKAs (51%) than that in cemented TKAs (22%, P < .01). However, the mean width of RLLs in the cementless TKAs (0.2 mm) was significantly smaller (P < .01) than that in the cemented TKAs (0.8 mm) at 1-year postoperatively with no progression.

Conclusion

A recently introduced cementless PS mobile-bearing TKA design demonstrated comparable postoperative and radiographical results to its cemented predecessor at 1-year follow-up.

Level of Evidence

Retrospective cohort study, Level III.

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Acknowledgements

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Funding

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Author notes

  1. Yoshinori Mikashima

    Present address: Oume Knee Surgery Center, Takagi Hospital, Imadera 5-18-19, Oume City, Tokyo, Japan

Authors and Affiliations

  1. Oume Knee Surgery Center, Takagi Hospital, Imadera 5-18-19, Oume City, Tokyo, Japan

    Hitoshi Imamura & Yoshiko Shirakawa

  2. Department of Orthopaedics, Tokyo Women’s Medical University, Tokyo, Japan

    Koichiro Yano, Katsunori Ikari & Ken Okazaki

Authors
  1. Yoshinori Mikashima
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  2. Hitoshi Imamura
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  6. Ken Okazaki
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Contributions

Y.M. and K.O. conceived the study design. Y.M. drafted the manuscript. K.I. and K.Y. verified the analytical methods. K.O. supervised the findings of this work. H.I and Y.S. assisted in the surgeries. All authors discussed the results and contributed to the final manuscript.

Corresponding author

Correspondence to Yoshinori Mikashima.

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Conflict of interest

Ken Okazaki serves as a consultant for DePuy Synthes and has also received honoraria for lectures from Smith and Nephew. Katsunori Ikari serves as a consultant and has received honoraria for lectures from Zimmer Biomet.

Ethical approval

The study was approved by the institutional review board of Oume Knee Surgery Center (Approval Number 001–2022). The study was performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. All surgeries were performed at the Oume Knee Surgery Center, and the study was conducted at both Oume Knee Surgery Center and Tokyo Women’s Medical University.

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Informed consent was obtained from all patients.

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Mikashima, Y., Imamura, H., Shirakawa, Y. et al. Modern cementless posterior stabilized mobile-bearing total knee arthroplasty shows comparable clinical and radiographical results to its cemented predecessor at 1-year follow-up. Knee Surg Sports Traumatol Arthrosc 30, 3131–3137 (2022). https://doi.org/10.1007/s00167-022-07047-7

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  • DOI: https://doi.org/10.1007/s00167-022-07047-7

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