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Evidence summaries

Cemented, Cementless or Hybrid Fixation Options in Total Knee Arthroplasty for Osteoarthritis and other Non-Traumatic Diseases

Cemented fixation in knee arthroplasty presents a smaller risk of displacement but a greater risk of future aseptic loosening than cementless fixation. Level of evidence: "A"

Summary

A Cochrane review [Abstract] 1 included 5 studies with a total of 297 subjects. Meta-analysis on roentgen stereophotogrammetric analysis (RSA) showed that cemented fixation of the tibial components demonstrated smaller displacement in relation to cementless fixation (with and without hydroxyapatite) after a follow-up of two years (maximum total point-motion, N = 167, two RCTs, MD 0.52 mm, 95% CI 0.31 to 0.74). However, the risk of future aseptic loosening with uncemented fixation was approximately half that of cemented fixation according to the arthroplasty instability classification (moderate quality as assessed by GRADE) inferred from RSA (N = 216, three RCTs, RR = 0.47, 95% CI 0.24 to 0.92) with a 16% absolute risk difference between groups. The number needed to treat for an additional beneficial outcome (NNTB) to prevent future aseptic loosening was 7 (95% CI 5 to 44).

Clinical comments

Note

Date of latest search: 2012-02-13

    References

    • Nakama GY, Peccin MS, Almeida GJ et al. Cemented, cementless or hybrid fixation options in total knee arthroplasty for osteoarthritis and other non-traumatic diseases. Cochrane Database Syst Rev 2012;10():CD006193. [PubMed]

Primary/Secondary Keywords