[Comparative study of fixation mode in total knee arthroplasty with preservation of the posterior cruciate ligament].
OBJECTIVE
We performed a prospective randomized study to compare two fixation modes, with and without cement, for total knee arthroplasty.


METHODS
The study series was composed of 96 cemented or noncemented total knee arthroplasties performed between May 1993 and October 1995. The only difference was the diamond interface used for cemented prostheses and the mesh interface used for uncemented prostheses. The operator was unaware of the type of fixation until the bone slices had been obtained. We assessed outcome in 73 cases with a mean follow-up of 27 months. The two populations were comparable for preoperative clinical status, bone tophicity and surgical procedure.


RESULTS
The mean duration of the operation was sgnificantly longer (> 10 min) for the cemented protheses. The complication rates were comparable but we did have two mobilizations of the tibial implant in the noncemented group. The total scores (127 +/- 29 in the cemented group versus 135 +/- 20 in the uncemented group) were significantly different. There were however more cases with degradation of the controlateral knee in the cemented group although the difference was not significant. When these cases were excluded from the analysis, the total scores for two groups were similar (143 and 140 respectively). Radiographic outcome was quite different with mobilization of the tibial implant in 2 cases and the rate of lucent borders was significantly higher in the noncemented group.


CONCLUSIONS
While the clinical outcome was comparable, the quality of the fixation was significantly better with cemented arthroplasty, which remains the gold standard.
Gicquel
P
P
Département d'Orthopédie-Traumatologie, Hôpital de Hautepierre, Strasbourg, France.
Kempf
J F
JF
Gastaud
F
F
Schlemmer
B
B
Bonnomet
F
F
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography
D001843:Bone Cements