Uncemented vs Cemented Cruciate Retaining Total Knee Arthroplasty in Patients With Body Mass Index Greater Than 30

J Arthroplasty. 2018 Apr;33(4):1082-1088. doi: 10.1016/j.arth.2017.11.043. Epub 2017 Dec 1.

Abstract

Background: Aseptic loosening of cemented and uncemented tibial components continues to be a source of implant failure after total knee arthroplasty (TKA) in the obese population. There is limited literature reviewing uncemented cruciate retaining (CR) components in the obese population.

Methods: A clinical and radiographic review was performed on 325 patients who underwent a cemented or uncemented TKA with a CR knee prosthesis and body mass index ≥30 kg/m2 between January 2010 and June 2013. Charts were reviewed for the incidence of revision due to aseptic loosening of the tibial baseplate, revision for any reason, incidence of radiolucent lines around the tibial baseplate, range of motion, and patient reported outcomes.

Results: There was no statistically significant difference between groups in survivorship for aseptic loosening of the tibial component (99.4% uncemented, 99.3% cemented, P = .94) and overall survivorship (98.1% uncemented, 98.3% cemented, P = .90). The Lower Extremity Activity Scale and Forgotten Joint Score-12 clinical outcome measures were similar between groups (10.2 ± 3.7 vs 9.7 ± 3.4 and 66.1 ± 28.2 vs 64.9 ± 24.3, P = .33, P = .78, respectively). Postoperative knee flexion was similar between groups (114.6 ± 9.3 vs 114.1 ± 9.3, P = .67).

Conclusion: Our study demonstrated similar survivorship of this CR design for aseptic loosening of the tibial baseplate and overall revision rates in obese patients undergoing either an uncemented or cemented TKA. The uncemented and cemented groups had comparable clinical and radiographic short to mid-term outcomes when implanted in good alignment when treating end-stage knee osteoarthritis.

Keywords: cementless; cruciate retaining; obese patient; total knee arthroplasty; uncemented.

MeSH terms

  • Adult
  • Aged
  • Arthroplasty, Replacement, Knee / instrumentation*
  • Arthroplasty, Replacement, Knee / methods*
  • Body Mass Index
  • Bone Cements / therapeutic use*
  • Female
  • Humans
  • Knee Prosthesis
  • Male
  • Middle Aged
  • Obesity / complications*
  • Obesity / surgery
  • Osteoarthritis, Knee / complications*
  • Osteoarthritis, Knee / surgery
  • Prosthesis Failure*
  • Range of Motion, Articular
  • Retrospective Studies
  • Tibia / surgery
  • Time Factors
  • Treatment Outcome

Substances

  • Bone Cements