A randomised controlled trial of cemented versus cementless press-fit condylar total knee replacement: 15-year survival analysis

J Bone Joint Surg Br. 2007 Dec;89(12):1608-14. doi: 10.1302/0301-620X.89B12.19363.

Abstract

We report the long-term survival of a prospective randomised consecutive series of 501 primary knee replacements using the press-fit condylar posterior cruciate ligament-retaining prosthesis. Patients received either cemented (219 patients, 277 implants) or cementless (177 patients, 224 implants) fixation. Altogether, 44 of 501 knees (8.8%) underwent revision surgery (24 cemented vs 20 cementless). For cemented knees the 15-year survival rate was 80.7% (95% confidence interval (CI) 71.5 to 87.4) and for cementless knees it was 75.3% (95% CI 63.5 to 84.3). There was no significant difference between the two groups (cemented vs cementless; hazard ratio (HR) 0.83, 95% CI 0.45 to 1.52, p = 0.55). When comparing the covariates there was no significant difference in the rates of survival between the side of operation (HR 0.58, p = 0.07), age (HR 0.97, p = 0.10) and diagnosis (HR 1.25 p = 0.72). However, there was a significant gender difference, with males having a higher failure rate with cemented fixation (HR 2.48, p = 0.004). Females had a similar failure rate in both groups. This single-surgeon series, with no loss to follow-up, provides reliable data of the revision rates of one of the most commonly-used total knee replacements. The survival of the press-fit condylar total knee replacement remained good at 15 years, irrespective of the method of fixation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Arthritis, Rheumatoid / surgery
  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / methods*
  • Bone Cements
  • Cementation / methods*
  • Female
  • Humans
  • Knee Prosthesis
  • Life Tables
  • Male
  • Osteoarthritis, Knee / surgery*
  • Osteolysis / diagnostic imaging
  • Osteolysis / etiology
  • Prosthesis Failure
  • Radiography
  • Reoperation / methods
  • Sex Factors
  • Survival Analysis
  • Treatment Outcome

Substances

  • Bone Cements