gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2013)

22.10. - 25.10.2013, Berlin

Full versus surface tibial cementation does not affect outcome after total knee arthroplasty

Meeting Abstract

  • presenting/speaker Jean-Yves Jenny - University Hospital Strasbourg, CCOM, ILLKIRCH, France
  • Olimpio Galasso - University Hospital Strasbourg, CCOM, ILLKIRCH, France
  • Rolf Miehlke - Gelenkzentrum Rhein-Main, Wiesbaden, Germany
  • Dominique Saragaglia - Hôpitaux Universitaires de Grenoble, Grenoble, France

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2013). Berlin, 22.-25.10.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocIN21-1146

doi: 10.3205/13dkou003, urn:nbn:de:0183-13dkou0034

Veröffentlicht: 23. Oktober 2013

© 2013 Jenny et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: The use of a stem in the tibia component has become a commonplace feature of orthopedic implants because of the stress decrease in the proximal tibia. The cementation of this stem might affect the future performance of the prosthesis and there is still contradictory evidence as to whether the use of cement around the tibia stem is an advantageous technique. To the best of our knowledge, no data are available on mid-term comparison of surface or full cementation of the tibia baseplate in TKA patients. We established the hypothesis that surface cementation versus full cementation will decrease the survival rate of a TKA.

Material: Three European university departments participated in the study. The same TKR model was implanted with a standardized operating technique with help of an imageless navigation system. Two centers (108 cases - group 1) cemented the tibia baseplate only, while the third one (124 cases - group 2) used a full cementation technique. 232 cases were prospectively followed for a minimal period of 5 years. There were 64 men and 168 women, with a mean age of 68 years, with a great majority of osteoarthritis (174 cases).

Methods: Survival rates, clinical and functional KSS, radiological results, complication and revision rates were compared in both groups with appropriate statistical test at a 5% level of significance. A multivariate analysis was performed to control for potential prognostic factors.

Results: With revision of either component for any reason as endpoint, the cumulative survival rate after 8 years was 96.6% in group 1 and 93.0% in group 2 (n.s.). With revision for mechanical reason as endpoint, the cumulative survival rate at 8 years was 100% in group 1 and 96.4% in group 2 (p=0.03). There was no significant between the two groups for clinical and functional results, radiological results, occurrence of complication and revision. No prognostic factor was observed.

Discussion: This study demonstrates that full cementation of the tibia baseplate stem in TKA has not true clinical benefit compared with horizontal technique, at least on mid-term. Metaphyseal bone cement removal in case of implant revision of full cemented baseplate it is time consuming and it may result in increased bone stock loss. Our findings together with controversial experimental data appear to discourage the routinely use of full cementation of the tibia component in TKA. Long-term follow-up will be required to confirm these findings.