A comparison study of
cemented total knee prostheses revealed no statistical
difference in survival curves, infections and other complications, according to
a study presented by Venceslav Pisot, MD, at the
SICOT XXV Triennial World Congress 2011.
“Trabecular tantalum cementless [prostheses] have advantages of
shorter operative time, better biological fixation with consequently potential
longevity and avoidance of adverse effect of bone cement,“ Pisot said
during his presentation.
For their study, Pisot and colleagues compared 455 cementless procedures
performed with the
NexGen total knee replacement (Zimmer, Warsaw, Ind.) and
trabecular metal monoblock tibial component (Zimmer) to 349 cemented procedures
using NexGen High-Flex (Zimmer) replacements. All of the arthroplasties were
performed between January 2005 and December 2009. There were twice as many
female patients in the study, Pisot said. The average patient body mass index
Mean follow-up was 3.6 years for the cementless group and 3.3 years for
the cemented cohort. During the course of the study, 17 patients died in the
cementless group and 18 patients died in the cemented cohort.
Pictured are control X-rays of bilateral
cementless knee prostheses at 5 months in the right knee (top) and at 5 years
in the left knee (bottom).
Images: Pisot V
The investigators discovered that the 4-year Kaplan Meyer survival rate
was not significantly different between the groups. The survival rate for the
cementless group was 97.1% and for the cemented group was 98.1%.
The researchers found that nine
total knee arthroplasties (TKAs) in the cementless group were
revised vs. eight in the cemented group. In the cementless group, one
prosthesis was rigid, one unstable, one malpositioned and one required a
patella resurfacing. In the cemented group, three patients needed patella
resurfacing, one suffered a periprosthetic fracture and one had a polyethylene
The cementless group had five infections, while the cemented group had
“Further investigation and clinical follow-up is warranted,”
Pisot said. – by Renee Blisard
- Pisot V, Levasic V, Kovac S, Milosev I. Comparison of 4-years
survival of cemented and cementless total knee prostheses. Paper #28997.
Presented at the SICOT XXV Triennial World Congress 2011. Sept. 6-9. Prague.
- Venceslav Pisot, MD, can be reached at Orthopaedic Hospital
Valdoltra, Jadranska c. 31, 6280 Ankaran, Slovenia; 386 05 66 96 100; email: