Fixation of stem in revision of total knee arthroplasty: cemented versus cementless—a meta-analysis

Purpose Revision of total knee arthroplasty (TKA) is growing rapidly all over the world. The introduction of intramedullary stems for additional stability in revision is well accepted by most of the surgeons, while the philosophy of stem fixation is still under controversy. A meta-analysis was perfo...

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Bibliographic Details
Published in:Knee Surgery, Sports Traumatology, Arthroscopy Sports Traumatology, Arthroscopy, 2016-10, Vol.24 (10), p.3200-3211
Main Authors: Wang, Changyao, Pfitzner, Tilman, von Roth, Philipp, Mayr, Hermann O., Sostheim, Michael, Hube, Robert
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement, Knee - methods
Bone Cements
Humans
Knee
Knee Prosthesis
Medicine
Medicine & Public Health
Orthopedics
Prosthesis Failure
Reoperation
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Summary:Purpose Revision of total knee arthroplasty (TKA) is growing rapidly all over the world. The introduction of intramedullary stems for additional stability in revision is well accepted by most of the surgeons, while the philosophy of stem fixation is still under controversy. A meta-analysis was performed to compare the survivorship of revised implants with regard to a cemented or cementless stem fixation. Methods Publications with patients who underwent revision TKA with minimum 24-month follow-up were systematically reviewed. Type of intramedullary stem fixation, failure rate for any reason, incidence of aseptic loosening and infection were extracted with follow-up interval specified. Random-effects meta-analysis was used to aggregate incidence data, which was compared between different fixation groups by fitting of logistic regression model. Results Seventeen observational studies were included in this meta-analysis. There was a similar likelihood of failure for any reason (risk ratio, RR 0.97), general reoperation (RR 1.02), aseptic loosening (RR 1.0) and infection (RR 1.0) in cemented stem fixation group compared to cementless stem fixation group with follow-up
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-015-3820-4