title: Long-term implant survivorship of cementless total knee arthroplasty: a systematic review of the literature and meta-analysis.
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.
authors: Department of Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors: Michael A
authors: MA
authors: Mont
authors: Department of Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors: Robert
authors: R
authors: Pivec
authors: Department of Orthopaedic Surgery, Seton Hall University of Health and Medical Sciences, Paterson, New Jersey.
authors: Kimona
authors: K
authors: Issa
authors: Department of Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors: Bhaveen H
authors: BH
authors: Kapadia
authors: Department of Orthopaedic Surgery, DownState Medical Institute, Brooklyn, New York.
authors: Aditya
authors: A
authors: Maheshwari
authors: Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, New York.
authors: Steven F
authors: SF
authors: Harwin
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001863:Bone Screws; D002484:Cementation; D006801:Humans; D007720:Knee Prosthesis; D008875:Middle Aged; D011475:Prosthesis Failure; D016032:Randomized Controlled Trials as Topic