AIMS Both the femoral and tibial component are usually cemented at revision total knee arthroplasty (rTKA), while stems can be added with either cemented or press-fit (hybrid) fixation. The aim of this study was to compare the long-term stability of rTKA with cemented and press-fitted stems, using radiostereometric analysis (RSA). METHODS This is a follow-up of a randomized controlled trial, initially involving 32 patients, of whom 19 (nine cemented, ten hybrid) were available for follow-up ten years postoperatively, when further RSA measurements were made. Micromotion of the femoral and tibial components was assessed using model-based RSA software (RSAcore). The clinical outcome was evaluated using the Knee Society Score (KSS), the Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analogue scale (pain and satisfaction). RESULTS The median total femoral translation and rotation at ten years were 0.39 mm (interquartile range (IQR) 0.20 to 0.54) and 0.59° (IQR 0.46° to 0.73°) for the cemented group and 0.70 mm (IQR 0.15 to 0.77) and 0.78° (IQR 0.47° to 1.43°) for the hybrid group. For the tibial components this was 0.38 mm (IQR 0.33 to 0.85) and 0.98° (IQR 0.38° to 1.34°) for the cemented group and 0.42 mm (IQR 0.30 to 0.52) and 0.72° (IQR 0.62° to 0.82°) for the hybrid group. None of these values were significantly different between the two groups and there were no significant differences between the clinical scores in the two groups at this time. There was only one re-revision, in the hybrid group, for infection and not for aseptic loosening. CONCLUSION These results show good long-term fixation with no difference in micromotion and clinical outcome between fully cemented and hybrid fixation in rTKA, which builds on earlier short- to mid-term results. The patients all had type I or II osseous defects, which may in part explain the good results. Cite this article: Bone Joint J 2022;104-B(7):875-883.

中文翻译：

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在翻修全膝关节置换术中，完全骨水泥固定和混合固定之间的长期微动没有差异：一项随机对照试验。

目的 股骨和胫骨组件通常在翻修全膝关节置换术 (rTKA) 时使用骨水泥，而假体可以通过骨水泥或压配（混合）固定方式添加。本研究的目的是使用放射立体测量分析 (RSA) 比较 rTKA 与骨水泥和压装柄的长期稳定性。方法 这是一项随机对照试验的后续行动，最初涉及 32 名患者，其中 19 名（9 名骨水泥，10 名混合）可在术后 10 年进行随访，当时进行了进一步的 RSA 测量。使用基于模型的 RSA 软件 (RSAcore) 评估股骨和胫骨组件的微动。使用膝关节协会评分（KSS）、膝关节损伤和骨关节炎结果评分（KOOS）和视觉模拟评分（疼痛和满意度）评估临床结果。结果 10 年时股骨总平移和旋转的中位数分别为 0.39 mm（四分位距 (IQR) 0.20 至 0.54）和 0.59°（IQR 0.46° 至 0.73°），骨水泥组和 0.70 mm（IQR 0.15 至 0.77）和 0.78混合组的°（IQR 0.47° 至 1.43°）。对于胫骨组件，骨水泥组为 0.38 mm（IQR 0.33 至 0.85）和 0.98°（IQR 0.38° 至 1.34°），骨水泥组为 0.42 mm（IQR 0.30 至 0.52）和 0.72°（IQR 0.62° 至 0.82°）混合组。两组之间这些值均无显着差异，此时两组的临床评分无显着差异。在混合组中，只有一次重新修订是针对感染而不是针对无菌性松动。结论 这些结果表明，在 rTKA 中，完全骨水泥固定和混合固定之间的微动和临床结果没有差异，这建立在早期的短期到中期结果的基础上，具有良好的长期固定。患者均存在 I 型或 II 型骨缺损，这可能部分解释了良好的结果。引用这篇文章：骨关节 J 2022;104-B(7):875-883。