Comparison of Cemented and Cementless Fixation in Total Knee Arthroplasty: A Meta-Analysis and Systematic Review of RCTs

Autor: Zirui Liu, Lei Wen, Libo Zhou, Zhongcheng Liu, Yi Chen, Bin Geng, Yayi Xia
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Orthopaedic Surgery, Vol 32 (2024)
Druh dokumentu: article
ISSN: 2309-4990
10225536
DOI: 10.1177/10225536241267270
Popis: Objective This study aimed to compare infection, aseptic loosening, revision, operation time, function scores, and the radiographic radiolucent line (RLL) between cementless and cemented fixation in total knee arthroplasty (TKA). Methods Articles reporting the outcomes of cemented and cementless TKA were searched in Medline, EMBASE, Web of Science, and the Cochrane Library. The search was conducted from articles published from January 1996 to May 2024. Odds Ratios (OR) and confidence intervals (CI) were used to measure the results. Cochrane Collaboration’s Review Manager software was used to perform the meta-analysis. Results Sixteen randomized controlled trials containing 2358 participants were included in this meta-analysis. Pooled data found that, in TKA, there were no significant differences between cemented fixation and cementless fixation for a prosthesis in infection, aseptic loosening and revision. The subgroup analysis and sensitivity analysis results of the knee society score (KSS) showed a significant difference favoring cementless fixation in a follow-up of less than 5 years (MD = −2.30, 95%CI –3.85 -0.74, p = .001) while favoring cemented fixation in a follow-up over 5 years (MD = 2.79, 95%CI 0.95 4.63, p = .003). The operation time of cementless was less than that of cemented (MD = 12.03, 95%CI 8.30 15.77, p < .00001). No significant difference was detected in knee society function score, Western Ontario and McMaster Universities osteoarthritis index, and RLL. There was no heterogeneity across studies ( p > .1), and most studies have a low risk of bias. Conclusions Within a follow-up period of less than 5 years, cementless TKA had better KSS, while over 5 years, KSS was better in cemented TKA, and cementless TKA required less operation time.
Databáze: Directory of Open Access Journals
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