Systematic review on non-cement prosthesis and bone cement prosthesis in total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2013.17.013

Abstract

Abstract:

BACKGROUND: The foreign researches have shown that, the bone cement prosthesis replacement accounted for 95.2% during total knee arthroplasty, but some experts believe that the use of bone cement for prosthesis fixation has high risk.
OBJECTIVE: To assess the effect difference of bone cement prosthesis and non-cement prosthesis replacement in total knee arthroplasty based on Cochrane system.
METHODS: The Medline database (from January 1996 to August 2011), Embase database (from January 1980 to August 2011), Cochranelibrary (August 2011), CBM database (from January 1990 to August 2011) and some other references were searched for the randomized controlled trials on bone cement prosthesis and non-cement prosthesis replacement in total knee arthroplasty. The quality of the included studies was assessed by Cochrane. RevMan 5.1.2 software was used for Meta-analysis. The differences of postoperative survival rate, stability, and related complications, revision rate and ectopic ossification of bone cement prosthesis and non-cement prosthesis were compared. CRADEpro version 3.2.2 software was used for evidence rating.
RESULTS AND CONCLUSION: Totally 1 381 cases form eight randomized controlled trials were involved. The cases were divided into the experimental group (bone cement group) and the control group (non-cement group), 676 cases in the experimental group and 705 cases in the control group. Four studies compared the knee survival rate in the less or equaled 5 years postoperative group, and the difference between two groups was significant, it illustrated that survival rate was higher in the bone cement group. Four studies compared knee survival rate in more than 5 years postoperative group, and the difference between two groups was significant, it illustrated that survival rate was higher in the non-cement group. Three studies compared the stability of postoperative prosthesis in different follow-up times in two groups and showed that there was no significant difference in the stability between two groups. Four studies compared the related complication of postoperative prosthesis in two groups in different follow-up times and showed that there was no significant difference in related complications between two groups. Five studies compared overhaul rates of postoperative prosthesis in two grups in different follow-up times and showed that there was no significant difference between two groups. Three studies compared ectopic ossification of postoperative prosthesis in two groups in different follow-up times and showed that there was no significant difference between two groups. The curative effect after operation in two groups was improved. The Meta-analysis results compared between the greater or less 5 years groups showed that survival rate of bone cement prosthesis was higher than that of non-cement prosthesis, and there was no significant difference in stability, related complications and overhaul rates, as well as ectopic ossification between two groups (P > 0.05).

Key words: bone and joint implants, evidence-based medicine of bone and joint implants, arthroplasty, joint replacement, bone cement prosthesis, non-cement prosthesis, prosthesis, bone cement, overhaul rate, ectopic ossification, stability, systematic evaluation

CLC Number:

R318

Chen Yue-ping, Chen Liang, Gao Hui, Luo Dong-fang, Yin Qing-shui. Systematic review on non-cement prosthesis and bone cement prosthesis in total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(17): 3132-3139.

Figures/Tables 6

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