A comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty: an updated systematic review and meta-analysis

Abstract Background Whether the cement should be used in the total knee arthroplasty (TKA) was still in controversy. This meta-analysis was performed to compare the efficacy of two kinds of fixation. Methods Randomized controlled trials (RCTs), prospective/retrospective observational studies from Pu...

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Main Authors: Yuan Liu, Yi Zeng, Yuangang Wu, Mingyang Li, Huiqi Xie, Bin Shen
Format: Article
Language:English
Published: BMC 2021-03-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-021-02299-4
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author Yuan Liu
Yi Zeng
Yuangang Wu
Mingyang Li
Huiqi Xie
Bin Shen
author_facet Yuan Liu
Yi Zeng
Yuangang Wu
Mingyang Li
Huiqi Xie
Bin Shen
author_sort Yuan Liu
collection DOAJ
description Abstract Background Whether the cement should be used in the total knee arthroplasty (TKA) was still in controversy. This meta-analysis was performed to compare the efficacy of two kinds of fixation. Methods Randomized controlled trials (RCTs), prospective/retrospective observational studies from PubMed (on 2019 September), EMBASE (on 2019 September), and the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science (on 2019 September) were searched. Only studies followed more than 2 years was included for the review. The PRISMA guidelines and Cochrane Handbook were adopted to assess the quality of the results reported in included studies to ensure that the results of our meta-analysis were reliable and veritable. The continuous and dichotomous outcomes were collected in a standard form, and the data were analyzed by Review Manager 5.3 software. Finally, the results were presented in the Forest plots. Results Twenty-six studies involving 2369 patients in cementless TKA and 2654 patients in cemented TKA were included. The rate of revision was not significantly different in two groups (p = 0.55). More than eight reasons caused revision were found in our study, the aseptic loosing was the most common, followed by the periprosthetic joint infection (PJI), neither was significantly different (p = 0.88 and 0.45, respectively). While significantly better long-term functional recovery was found in cementless TKA in terms of Knee Society Function Score (p = 0.004) and manipulation under anesthesia (p = 0.007). Conclusion Cementless fixation did not decrease the rate of revision after the total knee arthroplasty compared with the cemented fixation, while the long-term functional recovery was significantly better in the cementless group.
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spelling doaj.art-86e3d2d34ece4346b61483390d86d7272022-12-22T04:31:35ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-03-0116111410.1186/s13018-021-02299-4A comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty: an updated systematic review and meta-analysisYuan Liu0Yi Zeng1Yuangang Wu2Mingyang Li3Huiqi Xie4Bin Shen5Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityDepartment of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityDepartment of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityDepartment of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityDepartment of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityDepartment of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityAbstract Background Whether the cement should be used in the total knee arthroplasty (TKA) was still in controversy. This meta-analysis was performed to compare the efficacy of two kinds of fixation. Methods Randomized controlled trials (RCTs), prospective/retrospective observational studies from PubMed (on 2019 September), EMBASE (on 2019 September), and the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science (on 2019 September) were searched. Only studies followed more than 2 years was included for the review. The PRISMA guidelines and Cochrane Handbook were adopted to assess the quality of the results reported in included studies to ensure that the results of our meta-analysis were reliable and veritable. The continuous and dichotomous outcomes were collected in a standard form, and the data were analyzed by Review Manager 5.3 software. Finally, the results were presented in the Forest plots. Results Twenty-six studies involving 2369 patients in cementless TKA and 2654 patients in cemented TKA were included. The rate of revision was not significantly different in two groups (p = 0.55). More than eight reasons caused revision were found in our study, the aseptic loosing was the most common, followed by the periprosthetic joint infection (PJI), neither was significantly different (p = 0.88 and 0.45, respectively). While significantly better long-term functional recovery was found in cementless TKA in terms of Knee Society Function Score (p = 0.004) and manipulation under anesthesia (p = 0.007). Conclusion Cementless fixation did not decrease the rate of revision after the total knee arthroplasty compared with the cemented fixation, while the long-term functional recovery was significantly better in the cementless group.https://doi.org/10.1186/s13018-021-02299-4Total knee arthroplastyCementCementlessSystematical reviewMeta-analysis
spellingShingle Yuan Liu
Yi Zeng
Yuangang Wu
Mingyang Li
Huiqi Xie
Bin Shen
A comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty: an updated systematic review and meta-analysis
Journal of Orthopaedic Surgery and Research
Total knee arthroplasty
Cement
Cementless
Systematical review
Meta-analysis
title A comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty: an updated systematic review and meta-analysis
title_full A comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty: an updated systematic review and meta-analysis
title_fullStr A comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty: an updated systematic review and meta-analysis
title_full_unstemmed A comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty: an updated systematic review and meta-analysis
title_short A comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty: an updated systematic review and meta-analysis
title_sort comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty an updated systematic review and meta analysis
topic Total knee arthroplasty
Cement
Cementless
Systematical review
Meta-analysis
url https://doi.org/10.1186/s13018-021-02299-4
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