A randomised, controlled trial of cemented versus cementless press-fit condylar total knee replacement. Ten-year survival analysis.
We have carried out a long-term survival analysis of a prospective, randomised trial comparing cemented with cementless fixation of press-fit condylar primary total knee replacements. A consecutive series of 501 replacements received either cemented (219 patients, 277 implants) or cementless (177 patients, 224 implants) fixation. The patients were contacted at a mean follow-up of 7.4 years (2.7 to 13.0) to establish the rate of survival of the implant. The ten-year survival was compared using life-table and Cox's proportional hazard analysis. No patient was lost to follow-up. The survival at ten years was 95.3% (95% CI 90.3 to 97.8) and 95.6% (95% CI 89.5 to 98.2) in the cemented and cementless groups, respectively. The hazard ratio for failure in cemented compared with cementless prostheses was 0.97 (95% CI 0.36 to 2.6). A comparison of the clinical outcome at ten years in 80 knees showed no difference between the two groups. The survival of the press-fit condylar total knee replacement at ten years is good irrespective of the method of fixation and brings into question the use of more expensive cementless implants.
Khaw
F M
FM
Glenfield Hospital, Leicester, England.
Kirk
L M G
LM
Morris
R W
RW
Gregg
P J
PJ
D001172:Arthritis, Rheumatoid / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D002484:Cementation; D005260:Female; D006801:Humans; D007719:Knee Joint; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome