Cementless knee arthroplasty: a review of recent performance

被引:37
作者
Asokan, A. [1 ,2 ]
Plastow, R. [1 ,2 ]
Kayani, B. [1 ,2 ]
Radhakrishnan, G. T. [1 ,2 ]
Magan, A. A. [1 ,2 ]
Haddad, F. S. [1 ,2 ]
机构
[1] Univ Coll Hosp, Dept Trauma & Orthopaed Surg, London, England
[2] Princess Grace Hosp, Dept Orthopaed Surg, London, England
来源
BONE & JOINT OPEN | 2021年 / 2卷 / 01期
关键词
Cementless; Uncemented; Knee Arthroplasty; Total Knee Arthroplasty; Unicompartmental Knee Arthroplasty; Knee Replacement; NATIONAL JOINT REGISTRY; LONG-TERM OUTCOMES; FEMORAL COMPONENT; MATCHED PATIENTS; YOUNG-PATIENTS; REVISION RATE; FOLLOW-UP; FIXATION; REPLACEMENT; SURVIVAL;
D O I
10.1302/2633-1462.21.BJO-2020-0172.R1
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Cementless knee arthroplasty has seen a recent resurgence in popularity due to conceptual advantages, including improved osseointegration providing biological fixation, increased surgical efficiency, and reduced systemic complications associated with cement impaction and wear from cement debris. Increasingly younger and higher demand patients are requiring knee arthroplasty, and as such, there is optimism cementless fixation may improve implant survivorship and functional outcomes. Compared to cemented implants, the National Joint Registry (NJR) currently reports higher revision rates in cementless total knee arthroplasty (TKA), but lower in unicompartmental knee arthroplasty (UKA). However, recent studies are beginning to show excellent outcomes with cementless implants, particularly with UKA which has shown superior performance to cemented varieties. Cementless TKA has yet to show long-term benefit, and currently performs equivalently to cemented in short- to medium-term cohort studies. However, with novel concepts including 3D-printed coatings, robotic-assisted surgery, radiostereometric analysis, and kinematic or functional knee alignment principles, it is hoped they may help improve the outcomes of cementless TKA in the long-term. In addition, though cementless implant costs remain higher due to novel implant coatings, it is speculated cost-effectiveness can be achieved through greater surgical efficiency and potential reduction in revision costs. There is paucity of level one data on long-term outcomes between fixation methods and the cost-effectiveness of modern cementless knee arthroplasty. This review explores recent literature on cementless knee arthroplasty, with regards to clinical outcomes, implant survivorship, complications, and cost-effectiveness; providing a concise update to assist clinicians on implant choice.
引用
收藏
页码:48 / 57
页数:10
相关论文
共 82 条
[1]   Increased Aseptic Tibial Failures in Patients With a BMI ≥ 35 and Well-Aligned Total Knee Arthroplasties [J].
Abdel, Matthew P. ;
Bonadurer, George F., III ;
Jennings, Matthew T. ;
Hanssen, Arlen D. .
JOURNAL OF ARTHROPLASTY, 2015, 30 (12) :2181-2184
[2]   Postoperative Infection in Cementless and Cemented Total Knee Arthroplasty: A Propensity Score Matched Analysis [J].
Anis, Hiba K. ;
Ramanathan, Deepak ;
Sodhi, Nipun ;
Klika, Alison K. ;
Piuzzi, Nicolas S. ;
Mont, Michael A. ;
Higuera, Carlos A. ;
Molloy, Robert M. .
JOURNAL OF KNEE SURGERY, 2019, 32 (11) :1058-1062
[3]  
Australian Orthopaedic Association, 2020, National joint replacement registry annual reports
[4]   Higher revision risk for unicompartmental knee arthroplasty in low-volume hospitals [J].
Badawy, Mona ;
Espehaug, Birgitte ;
Indrekvam, Kari ;
Havelin, Leif I. ;
Furnes, Ove .
ACTA ORTHOPAEDICA, 2014, 85 (04) :342-347
[5]   Cemented vs Cementless Total Knee Arthroplasty in Morbidly Obese Patients [J].
Bagsby, Deren T. ;
Issa, Kimona ;
Smith, Langan S. ;
Elmallah, Randa K. ;
Mast, Logan E. ;
Harwin, Steven F. ;
Mont, Michael A. ;
Bhimani, Samrath J. ;
Malkani, Arthur L. .
JOURNAL OF ARTHROPLASTY, 2016, 31 (08) :1727-1731
[6]   Center and Surgeon Volume Influence the Revision Rate Following Unicondylar Knee Replacement [J].
Baker, Paul ;
Jameson, Simon ;
Critchley, Rebecca ;
Reed, Mike ;
Gregg, Paul ;
Deehan, David .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2013, 95A (08) :702-709
[7]   Five-year clinical and radiological outcomes in 257 consecutive cementless Oxford medial unicompartmental knee arthroplasties [J].
Blaney, J. ;
Harty, H. ;
Doran, E. ;
O'Brien, S. ;
Hill, J. ;
Dobie, I. ;
Beverland, D. .
BONE & JOINT JOURNAL, 2017, 99-B (05) :623-631
[8]   Discharge on the day of surgery following unicompartmental knee arthroplasty within the United Kingdom NHS [J].
Bradley, B. ;
Middleton, S. ;
Davis, N. ;
Williams, M. ;
Stocker, M. ;
Hockings, M. ;
Isaac, D. L. .
BONE & JOINT JOURNAL, 2017, 99B (06) :788-792
[9]  
Campbell MD, 1998, CLIN ORTHOP RELAT R, P58
[10]   Ten-year survival and seven-year functional results of cementless Oxford unicompartmental knee replacement A prospective consecutive series of our first 1000 cases [J].
Campi, S. ;
Pandit, H. ;
Hooper, G. ;
Snell, D. ;
Jenkins, C. ;
Dodd, C. A. F. ;
Maxwell, R. ;
Murray, D. W. .
KNEE, 2018, 25 (06) :1231-1237