Cementless and Cemented Dual-Pivot Total Knee Arthroplasty: A Matched Comparison With a Minimum Two-Year Follow-Up

Abstract

Background: With the use of newer biomaterials, many authors have reported similar results between cementless and cemented total knee arthroplasty (TKA). The purpose of this study was to compare the early clinical and radiographic outcomes of cementless and cemented TKA using the same dual-pivot articulation.

Methods: A consecutive series of 806 TKAs were implanted by a single surgeon using the same dual-pivot articulation. There were 634 TKAs (79%) cemented and 172 (21%) uncemented. One patient in the cementless group was lost before two years. The remaining 171 cementless TKAs were matched 1:1 with cemented TKAs with respect to age, sex, and body mass index. All patients were followed for a minimum of two years (range, 24-66 months) using the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement , and Knee Society clinical and radiographic evaluation. The average follow-up was 3.8 years (range, 24-66 months) in the cemented group and 3.4 years (range, 24-56 months) in the cementless group.

Results: At final follow-up, the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement was higher in the cementless group (86 points (range, 64-100) versus 80 points (range, 57-100). Postoperative Knee Society scores (including pain and function) were similar. There was one deep infection (cemented TKA). The manipulation rate was 1.2% in the cementless group and 2.4% in the cemented TKA group. Excluding infection, two knees (1.2%) were revised in each group. No cases of femoral or tibial component loosening were identified.

Conclusion: Patients implanted with either a cemented or cementless TKA using the same conforming dual-pivot articulation design had similar early outcomes and functional improvements. The type of fixation did not appear to influence the early clinical results.

Keywords: cemented total knee arthroplasty; cementless total knee arthroplasty; dual-pivot design; matched comparison; press-fit.