Study finds, Lower revision rates for cemented fixation in a
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It is still unclear whether cemented or uncemented fixation has the best long-term survival in primary total knee arthroplasty (TKA). The mobile-bearing (MB) knee device with Low Contact Stress (LCS) was first implemented in 1977. The aim of this study is to see how long this design will last with a minimum of 15 years of follow-up.

A retrospective analysis was performed, with the primary endpoint for survival defined as revision. Cox regression analysis was performed to assess the association between type of fixation and the risk of revision, while correcting for potential confounders (diagnosis, design, age and sex).

--1271 cases were included with inflammatory joint disease (IJD) and non-IJD.

--TKAs were performed cemented in 522 cases and uncemented in 749 cases.

--A bicruciate retaining design was used in 180 cases, a rotating platform design in 174 cases and an anterior posterior glide posterior cruciate-retaining (PCR) design in 916 cases.

--Cumulative incidence of component revision at 15 years was 2.7% for cemented and 10% for uncemented TKA, respectively.

--The 20-year cumulative incidence was 2.9% for cemented and 10.9% for uncemented TKA, respectively.

--Age, non-IJD and PCR design were associated with a significantly higher risk of revision, regardless of the type of fixation.

Long-term survival for patients undergoing cemented or uncemented TKA using the LCS MB method showed lower cemented fixation revision rates. Regardless of the form of fixation, the risk of revision was higher in younger, non-IJD patients who had the PCR template. It is suggested that cemented fixation be used for the LCS MB TKA design.