Treatment efficacy of cementless versus cemented prosthesis in primary total knee arthroplasty: a meta-analysis

doi:10.3969/j.issn.2095-4344.1301

Abstract

Abstract:

BACKGROUND: For patients who need total knee arthroplasty, whether to use cementless or cementless fixation, which fixation method has more advantages in clinical efficacy, functional activity and prosthesis survival rate are controversial.

OBJECTIVE: To compare the efficacy of cementless and cemented fixations in primary total knee arthroplasty by meta-analysis in order to evaluate the best fixation method.

METHODS: PubMed, EMbase, Cochrane Library, CNKI, WanFang and CBM databases were searched. All randomized controlled trials on the efficacy of cementless and cemented fixations in primary total knee arthroplasty before June 2018 were collected. Two researchers independently screened the literature according to the inclusion and exclusion criteria, then extracted data, and conducted quality evaluation. RevMan 5.3 software was used for meta-analysis.

RESULTS AND CONCLUSION: (1) Seven randomized controlled trials were included, involving 743 patients. (2) Meta-analysis results showed that there was no significant difference in the primary measurement outcome, survival rate of prosthesis [RR=1, 95%CI (0.98, 1.02), P=0.90]. (3) Secondary measurement outcomes, Knee Society Score [MD=0.28, 95%CI (-1.04, 1.61), P=0.68], Western Ontario and McMaster Universities Osteoarthritis Index score [MD=1.63, 95%CI (-0.17, 3.43), P=0.08], blood loss (intraoperative bleeding + drainage) [MD=408.52, 95%CI (-102.18, 919.22), P=0.12], incidence of joint infection [RR=0.97, 95%CI (0.34, 2.73), P=0.95] had no significant difference between two groups. The range of motion in the cementless group was superior to the cemented group [MD=3.46, 95%CI (1.12, 5.80), P=0.004]. Cementless fixation was better than bone cement fixation in clear line [RR=1.67, 95%CI (1.14, 2.46), P=0.009]. (4) In summary, for patients undergoing primary total knee arthroplasty, the effect of cementless fixation is similar to that of cemented fixation, but both of them have certain advantages in terms of joint range of motion and clear line.

Key words: total knee arthroplasty, cemented, cementless, prosthesis, fixation, meta-analysis, randomized controlled trials, the National Natural Science Foundation of China

CLC Number:

R459.9

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R459.9

Zhao Jiangbo, Tian Jianing, Li Yan, Chen Desheng.

Treatment efficacy of cementless versus cemented prosthesis in primary total knee arthroplasty: a meta-analysis

[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(24): 3916-3923.

Figures/Tables 7

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