Cementless and cemented total knee arthroplasty in patients younger than fifty five years. Which is better?

Abstract

Purpose: The purpose of this prospective, randomised study was to evaluate long-term clinical results, radiographic findings, complications and revision and survivorship rates in patients <55 years at a minimum of 16 years after undergoing bilateral, sequential, simultaneous, cemented and cementless total knee arthroplasties (TKAs) in the same patients.

Methods: Bilateral, sequential, simultaneous TKAs were performed in 80 patients (160 knees). There were 63 women and 17 men with a mean age of 54.3 years (range 49-55), who received a cementless prosthesis in one knee and a cemented prosthesis in the other. The mean follow-up was 16.6 years (range 16-17).

Results: At final review, the mean Knee Society (KS) knee scores (95.8 versus 96.9), Western Ontario and McMaster Universities (WOMAC) osteoarthritis (OA) index (25.4 versus 25.9), range of motion (ROM) (125° versus 128°), patient satisfaction (8.1 versus 8.3) and radiological results were similar in both groups. Femoral component survival rate was 100% in both groups at 17 years; at 17 years, the cemented tibial component survival rate was 100% and the cementless tibial component 98.7%. No osteolysis was identified in either group.

Conclusion: Long-term results of both cementless and cemented TKAs were encouraging in patients with OA who were <55 years. However, we found no evidence to prove the superiority of cementless over cemented TKAs.

Figures

Fig. 1

Consolidated Standards of Reporting Trials (CONSORT) flow diagram of patients in the study

Fig. 2

Radiographs of a 53-year-old woman with bilateral osteoarthritis of the knee in a the supine anteroposterior view and b lateral views 17 years postoperatively. The cementless (right knee) and cemented (left knee) NexGen posterior-cruciate-retaining prostheses firmly embedded in a satisfactory position, with no radiolucent lines and no osteolysis around the component in either knee