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J Knee Surg 2014; 27(05): 369-376
DOI: 10.1055/s-0033-1361952
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Long-Term Implant Survivorship of Cementless Total Knee Arthroplasty: A Systematic Review of the Literature and Meta-Analysis

Michael A. Mont
1   Department of Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Robert Pivec
1   Department of Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Kimona Issa
2   Department of Orthopaedic Surgery, Seton Hall University of Health and Medical Sciences, Paterson, New Jersey
,
Bhaveen H. Kapadia
1   Department of Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Aditya Maheshwari
3   Department of Orthopaedic Surgery, DownState Medical Institute, Brooklyn, New York
,
Steven F. Harwin
4   Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, New York
› Author Affiliations
Further Information

Publication History

25 September 2013

27 October 2013

Publication Date:
07 December 2013 (online)

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Abstract

Cementless total knee arthroplasty (TKA) has had limited use in the United States, however, recent reports have demonstrated promising results, but there has been no meta-analysis to examine these outcomes in the past 5 years. In this review, 37 studies (2,940 patients and 3,568 TKAs) were identified and used, comparing cementless to cemented TKA. Pooled implant survivorship was compared using a fixed-effect meta-analysis between cementless and cemented TKA, and between cementless TKA with and without screw fixation. Cementless TKA had implant survivorship comparable to cemented TKA (odds ratio, 1.1; 95% confidence interval [CI], 0.62–2.00). The mean survivorship at 10 years for cementless TKA was 95.6% compared with 95.3% for cemented TKA. At 20-year follow-up, implant survivorship decreased to 76 and 71%, respectively. No difference was observed between fixation with or without screws (OR, 1.1; 95% CI, 0.16–7.5). Implant survivorship for cementless TKA was comparable to the current gold standard cemented TKAs.

Keywords

total knee arthroplasty - cementless
 

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