A prospective randomised controlled trial of cemented and uncemented tibial baseplates: functional and radiological outcomes.
Cementless
Randomised controlled trial
Survivorship
Tibial fixation
Total knee replacement
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
09
05
2022
accepted:
28
02
2023
medline:
28
8
2023
pubmed:
1
4
2023
entrez:
31
3
2023
Statut:
ppublish
Résumé
With the success of uncemented fixation in younger patients undergoing total hip arthroplasty and the growing demand for total knee arthroplasty (TKA) in a younger cohort of patients, there has been an increasing interest in cementless tibial baseplate fixation. We sought to determine whether there was a clear advantage to the use of three different forms of tibial baseplate fixation. The primary outcome of this study was survivorship and secondary outcomes were functional and radiological outcomes, up until 10 years. We conducted a randomised controlled trial and recruited 224 patients with 274 knees. Patients underwent TKA by a single surgeon utilising a standard surgical technique. All patients received a cruciate retaining TKA with a cementless femoral component, and were randomised to receive either a cemented tibial component, a pegged porous coated cementless tibial component with screws or a cementless tantalum monoblock tibial component with pegs. Patient reported outcome measures (PROMS), radiological data and survivorship were assessed until 10 years post-operatively. Pre-operative range of motion, alignment and PROMS were similar between the three groups. The use of cemented, cementless with screws or cementless with pegs fixation options, lead to differences in functional outcomes. There was greater improvement in the Oxford score and Knee Society Score in patients who received a cemented baseplate compared to tantalum and the pegged porous groups. However, radiological and survival outcomes were similar in all three groups. Overall survivorship was 99.6%, with one knee with cementless tibial fixation and screws revised for subsidence at 3 years. There were no cases of venous thromboembolism, periprosthetic fracture or infection. Irrespective of tibial fixation method, functional and radiological outcomes remain similar at follow-up at 10 years, with no clear difference in outcome between each group. Each method of fixation also had excellent survivorship over this period and should reassure surgeons that whichever method of fixation they choose, long-term outcomes are likely to be satisfactory.
Identifiants
pubmed: 37000266
doi: 10.1007/s00402-023-04831-z
pii: 10.1007/s00402-023-04831-z
doi:
Substances chimiques
Tantalum
6424HBN274
Bone Cements
0
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5891-5899Informations de copyright
© 2023. Crown.
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