DALLAS — Results presented at the American Association of Hip and Knee Surgeons Annual Meeting showed excellent results when a recently introduced cementless design was used in total knee arthroplasty.
Denis Nam, MD, MSc, and colleagues randomly assigned 147 patients with osteoarthritis to undergo TKA with either a cemented or cementless design. Researchers collected intraoperative variables and clinical outcome scores at 4- to 6-week, 1- and 2-year follow-ups.
“In addition, patients were asked to rate their knee as a percentage of normal, their overall health and their satisfaction,” Nam said in his presentation here.
At 2-year follow-up, Nam noted investigators had follow-up on 141 patients. Of these patients, 65 had cemented knee replacements and 76 had cementless knee replacements. Results showed patients in the cementless cohort had a decrease in operative time. However, the two cohorts had no significant differences in estimated blood loss or change in hemoglobin from preoperative measures to postoperative day 1, according to Nam.
“At 4- to 6-week follow-up, we found no differences in patients reporting no pain in their knee replacement between the two groups,” Nam said. “The VAS score was the same between the two cohorts in the cemented and cementless group.”
He added patients had no differences in the change in Oxford Knee Score, Knee Society functional score or the Forgotten Joint Score at 2-year follow-up.
“In the cemented cohort, the mean rating for percent of normal was 88% vs. 87% in the cementless cohort,” Nam said.
Nam also said 68% of patients in the cemented group reported they were satisfied with their knee replacement vs. 75% of patients in the cementless group. He noted one revision and zero revisions in the cemented and cementless cohorts, respectively.
“There were no clinically significant differences in the amount of radiolucencies between the two groups, although there was a statistically significant difference for the tibia and for the femur,” Nam said. “I believe that, most importantly, no total knee replacements demonstrated progressive radiolucencies over time or signs of aseptic failure.” – by Casey Tingle
Nam D, et al. Paper 3. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 1-4, 2018; Dallas.
Disclosure: Nam reports he is a paid consultant for KCI, Stryker and Zimmer; and receives research support from KCI and Zimmer.