Comparison of the early postoperative outcomes of cementless and cemented medial unicompartmental knee arthroplasty: results from the Dutch National Arthroplasty Registry
| Autor: | Tarik Bayoumi, Joost A. Burger, Jelle P. van der List, Inger N. Sierevelt, Anneke Spekenbrink-Spooren, Andrew D. Pearle, Gino M. M. J. Kerkhoffs, Hendrik A. Zuiderbaan |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: |
unicompartmental knee arthroplasty
patient-reported outcomes implant survival registry cementless fixation technique minimal important change cemented medial unicompartmental knee arthroplasty unicompartmental knee arthroplasty (uka) patient-reported outcome measures (proms) oxford knee score periprosthetic fractures cementless fixation cementless implants arthroplasty registry cox regression models cemented implants Orthopedic surgery RD701-811 |
| Zdroj: | Bone & Joint Open, Vol 5, Iss 5, Pp 401-410 (2024) |
| Druh dokumentu: | article |
| ISSN: | 2633-1462 |
| DOI: | 10.1302/2633-1462.55.BJO-2024-0007.R1 |
| Popis: | Aims: The primary objective of this registry-based study was to compare patient-reported outcomes of cementless and cemented medial unicompartmental knee arthroplasty (UKA) during the first postoperative year. The secondary objective was to assess one- and three-year implant survival of both fixation techniques. Methods: We analyzed 10,862 cementless and 7,917 cemented UKA cases enrolled in the Dutch Arthroplasty Registry, operated between 2017 and 2021. Pre- to postoperative change in outcomes at six and 12 months’ follow-up were compared using mixed model analyses. Kaplan-Meier and Cox regression models were applied to quantify differences in implant survival. Adjustments were made for patient-specific variables and annual hospital volume. Results: Change from baseline in the Oxford Knee Score (OKS) and activity-related pain was comparable between groups. Adjustment for covariates demonstrated a minimally greater decrease in rest-related pain in the cemented group (β = -0.09 (95% confidence interval (CI) -0.16 to -0.01)). Cementless fixation was associated with a higher probability of achieving an excellent OKS outcome (> 41 points) (adjusted odds ratio 1.2 (95% CI 1.1 to 1.3)). The likelihood of one-year implant survival was greater for cemented implants (adjusted hazard ratio (HR) 1.35 (95% CI 1.01 to 1.71)), with higher revision rates for periprosthetic fractures of cementless implants. During two to three years’ follow-up, the likelihood of implant survival was non-significantly greater for cementless UKA (adjusted HR 0.64 (95% CI 0.40 to 1.04)), primarily due to increased revision rates for tibial loosening of cemented implants. Conclusion: Cementless and cemented medial UKA led to comparable improvement in physical function and pain reduction during the initial postoperative year, albeit with a greater likelihood of achieving excellent OKS outcomes after cementless UKA. Anticipated differences in early physical function and pain should not be a decisive factor in the choice of fixation technique. However, surgeons should consider the differences in short- and long-term implant survival when deciding which implant to use. Cite this article: Bone Jt Open 2024;5(5):401–410. |
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