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...
Main Authors: | , , , , , |
---|---|
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 |
_version_ | 1811182728899461120 |
---|---|
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. |
first_indexed | 2024-04-11T09:36:43Z |
format | Article |
id | doaj.art-86e3d2d34ece4346b61483390d86d727 |
institution | Directory Open Access Journal |
issn | 1749-799X |
language | English |
last_indexed | 2024-04-11T09:36:43Z |
publishDate | 2021-03-01 |
publisher | BMC |
record_format | Article |
series | Journal of Orthopaedic Surgery and Research |
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 |
work_keys_str_mv | AT yuanliu acomprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT yizeng acomprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT yuangangwu acomprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT mingyangli acomprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT huiqixie acomprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT binshen acomprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT yuanliu comprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT yizeng comprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT yuangangwu comprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT mingyangli comprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT huiqixie comprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis AT binshen comprehensivecomparisonbetweencementlessandcementedfixationinthetotalkneearthroplastyanupdatedsystematicreviewandmetaanalysis |