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J Knee Surg. 2014 Oct;27(5):369-76. doi: 10.1055/s-0033-1361952. Epub 2013 Dec 7.

Long-term implant survivorship of cementless total knee arthroplasty: a systematic review of the literature and meta-analysis.

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Department of Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
Department of Orthopaedic Surgery, Seton Hall University of Health and Medical Sciences, Paterson, New Jersey.
Department of Orthopaedic Surgery, DownState Medical Institute, Brooklyn, New York.
Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, New York.


Cementless total knee arthroplasty (TKA) has had limited use in the United States, however, recent reports have demonstrated promising results, but there has been no meta-analysis to examine these outcomes in the past 5 years. In this review, 37 studies (2,940 patients and 3,568 TKAs) were identified and used, comparing cementless to cemented TKA. Pooled implant survivorship was compared using a fixed-effect meta-analysis between cementless and cemented TKA, and between cementless TKA with and without screw fixation. Cementless TKA had implant survivorship comparable to cemented TKA (odds ratio, 1.1; 95% confidence interval [CI], 0.62-2.00). The mean survivorship at 10 years for cementless TKA was 95.6% compared with 95.3% for cemented TKA. At 20-year follow-up, implant survivorship decreased to 76 and 71%, respectively. No difference was observed between fixation with or without screws (OR, 1.1; 95% CI, 0.16-7.5). Implant survivorship for cementless TKA was comparable to the current gold standard cemented TKAs.

[Indexed for MEDLINE]

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