Cemented, cementless TKR have equivalent 10-year implant survival rates
Both cemented and cementless total knee replacements have 10-year implant survivorship rates of greater than 95%, while cementless implants have higher revision and reoperation rates, according to published results.
Researchers used the National Joint Registry to compare propensity score-matched cohorts of 22,477 cemented TKRs and 22,477 cementless TKRs. The researchers performed linear regression analysis to compare survivorship, revision, reoperation and mortality across different ages in both cohorts.
According to the study, 10-year implant survivorship with revision as the end point was 96% in the cemented cohort and 95.5% in the cementless cohort (HR = 1.14; P = .01). With reoperation as the end point, 10-year survivorship was 82.7% in the cemented cohort and 81.4% in the cementless cohort (HR = 1.08; P = .001).
The researchers also noted cementless TKRs had a higher revision rate (absolute difference, 0.5%) and reoperation rate (absolute difference, 1.3%) compared with cemented TKRs. Additionally, in comparing the cementless group to the cemented group, the rate of revision for infection was lower (0.5% vs. 0.7%; P = .003), but the rate of revision for pain was higher (0.7% vs. 0.5%; P = .002). Overall, outcomes did not significantly differ between age groups, the researchers added.
“Cementless components may have slightly better results than cemented components in very young patients, and modern designs of cementless TKR may perform better than cemented TKR,” the researchers wrote in the study. “Both topics require further study.”