Comparable mid-term revision rates of primary cemented and cementless total knee arthroplasties in 201,211 cases in the Dutch Arthroplasty Register (2007-2017).,Knee Surgery, Sports Traumatology, Arthroscopy

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Comparable mid-term revision rates of primary cemented and cementless total knee arthroplasties in 201,211 cases in the Dutch Arthroplasty Register (2007-2017).
Knee Surgery, Sports Traumatology, Arthroscopy ( IF 3.8 ) Pub Date : 2020-08-30 , DOI: 10.1007/s00167-020-06183-2
Casper R Quispel _{1,

2} , Tijs Duivenvoorden ₃ , Stefan R Beekhuizen ₁ , Hennie Verburg ₃ , Anneke Spekenbrink-Spooren ₄ , Liza N Van Steenbergen ₄ , Jantsje H Pasma ₁ , Ruud De Ridder ₂

Affiliation

Purpose

Long-term failure of total knee arthroplasty (TKA) is mostly due to loosening of the prosthesis. In this study, the short- and mid-term revision rates of cemented vs cementless TKAs were investigated. Comparable short- and mid-term survival rates of both fixation methods were expected.

Methods

Data on all cemented and cementless TKAs performed between 2007 and 2017 were retrieved from the Dutch Arthroplasty Register. The cumulative crude incidence of revision of cemented and cementless TKA was calculated. Death was considered a competing risk. Revision rates were compared using multivariable Cox proportional hazard regression analysis. The associations between fixation method and type of revision or reason for revision were tested using logistic regression analyses.

Results

In total, 190,651 (94.8%) cemented and 10,560 (5.3%) cementless TKAs were evaluated. Both groups had comparable case characteristics. Cemented TKAs were inserted more often in cases with previous knee surgery compared to cementless TKAs (32% vs 27%). The cumulative incidence of revision after 9 years was 5.5% (CI 5.3–5.6%) for cemented and 5.8% (CI 5.2–6.4%) for cementless TKAs (p = 0.2). Cementless TKAs were more often revised due to loosening of the tibial (27% vs 18%; p < 0.001) or the femoral component (7% vs 5%; p = 0.005) than cemented TKAs. Cemented TKAs were more often revised due to infection (17% vs 9%; p = 0.004) than cementless TKAs.

Conclusion

In conclusion, cemented and cementless TKAs have comparable short- and mid-term revision rates based on a nationwide register study.

Level of evidence

III.

中文翻译：

荷兰关节成形术登记册 (2007-2017) 中 201,211 例初次骨水泥和非骨水泥全膝关节置换术的中期翻修率相当。

目的

全膝关节置换术（TKA）的长期失败主要是由于假体松动。在这项研究中，研究了骨水泥与非骨水泥 TKA 的短期和中期翻修率。预计两种固定方法的短期和中期存活率相当。

方法

2007 年至 2017 年间进行的所有骨水泥和非骨水泥 TKA 的数据均来自荷兰关节置换术登记处。计算骨水泥和非骨水泥 TKA 翻修的累积粗发生率。死亡被认为是一种竞争风险。使用多变量 Cox 比例风险回归分析比较修订率。使用逻辑回归分析测试固定方法与修订类型或修订原因之间的关联。

结果

总共评估了 190,651 (94.8%) 个骨水泥和 10,560 (5.3%) 非骨水泥 TKA。两组具有可比的病例特征。与非骨水泥型 TKAs 相比，骨水泥型 TKAs 在既往膝关节手术病例中植入的频率更高（32% 对 27%）。9 年后，骨水泥型 TKA 的累积翻修发生率为 5.5% (CI 5.3–5.6%)，非骨水泥型 TKA 为 5.8% (CI 5.2–6.4%) ( p = 0.2)。由于胫骨（27% 对 18%；p < 0.001）或股骨假体（7% 对 5%；p = 0.005）的松动，非骨水泥 TKA 比骨水泥 TKA更常被翻修。与非骨水泥 TKA 相比，骨水泥 TKA更常因感染而翻修（17% 对 9%；p = 0.004）。