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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n\u003Cp id=\u0022p-1\u0022\u003EWhen cementless fixation is used for total knee arthroplasty, functional outcomes are noninferior to those seen with cemented fixation at 2 years, and patients report similar satisfaction. There is a small but significant improvement in clinical outcome with cemented fixation, and early pain scores are slightly lower. Additional research is needed to determine whether a cementless approach improved long-term survival.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Etotal knee arthroplasty\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecementless fixation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecemented fixation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehip \u0026amp; knee conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eorthopaedics \u0026amp; sports medicine clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eorthopaedic procedures\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n\n\u003Cp id=\u0022p-2\u0022\u003EIn a clinical study reported by Kevin B. Fricka, MD, Anderson Orthopaedic Clinic, Alexandria, Virginia, USA, patients receiving total knee arthroplasty (TKA) using cementless fixation had similar clinical and functional scores and equivalent levels of satisfaction compared with those receiving cemented TKA after 2 years.\u003C\/p\u003E\n\u003Cp id=\u0022p-3\u0022\u003ECemented TKA is associated with excellent long-term survival and is the preferred approach for the majority of surgeons. Cementless TKA, while having favorable long-term results on the femoral side [Baker PN et al. \u003Cem\u003EJ Bone Joint Surg Br.\u003C\/em\u003E 2007], has been associated with failure related to the tibial or patellar components. This was a prospective single-surgeon study designed to assess clinical outcomes, patient satisfaction, and long-term (15 years) survival in 92 TKA patients randomized to cemented (n\u2005=\u200545) or cementless (n\u2005=\u200547) fixation. The cementless implants consisted of a porous fiber-metal mesh femoral component and a trabecular metal modular tibial component; the cemented implants were precoated femoral and tibial components. All designs were fixed bearing and cruciate retaining. Knee Society Scores and Oxford Knee Scores were collected prior to surgery and at 4 weeks, 4 months, and 1 and 2 years. Pain was assessed using a visual analog scale preoperatively and at 4 weeks and 4 months. Alignment was assessed using radiographic analysis. Postoperative complications were recorded. All patients received routine antibiotic and aspirin prophylaxis, and all had identical rehabilitation protocols.\u003C\/p\u003E\n\u003Cp id=\u0022p-4\u0022\u003EThe cementless approach was associated with a shorter surgical time (74 vs 81 minutes) but no difference in blood loss. Early pain scores (at 4 months) were higher, but not significantly so, in the cementless group. Dr Fricka suggested that this was likely due to the time needed for osseointegration. Knee Society Scores showed no difference in function at 2 years, but patients in the cemented group had slightly higher clinical scores (96.3 vs 92.3; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.3). Oxford Knee Scores and patient-reported satisfaction, pain levels, and improved function were similar. There were 2 revisions: 1 in the cementless group for instability and 1 in the cemented group for infection. Overall limb alignment was similar on radiographic analysis (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). A nonprogressive radiolucency was identified in 11 patients in the cementless group (vs none in the cemented group). Varus subsidence of the tibia was noted in 4 knees in the cementless group; none have required revision. Of the 11 patients who had staged bilateral TKA with 1 cemented and 1 cementless fixation, 9 patients had no preference, and 2 preferred the cementless design.\u003C\/p\u003E\n\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16278\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16278\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16278\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003ERadiographic Outcomes: Long Alignment Tibiofemoral Angle at 2 Years\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cp id=\u0022p-7\u0022\u003EThis study is limited by its small sample size (although it was sufficient to perform a power analysis) and short follow-up. Additional follow-up is planned for these patients at 5, 10, and 15 years to assess whether cementless fixation provides an overall survivorship advantage.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/7\/7.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlpmq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlpmq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}