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Background: In primary Total Knee Arthroplasty (TKA), it is still not clear if cemented or uncemented fixation has the best long-term survival. The Low Contact Stress (LCS) mobile-bearing (MB) knee system was introduced in 1977. The aim of this study is to investigate the long-term survival of this design with a minimum of 15-year follow-up.

Methods: 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).

Results: 1271 cases were included with inflammatory joint disease (IJD) (657 cases) and non-IJD (614 cases). 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% (95% CI 1.6; 4.5) for cemented and 10% (95% CI 8.1; 12.4) for uncemented TKA, respectively. The 20-year cumulative incidence was 2.9% (95% CI 1.7; 4.7) for cemented and 10.9% (95% CI 8.8; 13.4) 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.

Conclusion: Long-term survival for patients undergoing cemented or uncemented TKA using the LCS MB system revealed lower revision rates for cemented fixation. Revision risk was higher in younger, non-IJD patients who had the PCR design, regardless of the type of fixation. For the LCS MB TKA design, it is recommended to use cemented fixation.

Titel:	Lower revision rates for cemented fixation in a long-term survival analysis of three different LCS designs.
Autor/in / Beteiligte Person:	van Ooij B ; de Keijzer DR ; Hoornenborg, D ; Sierevelt, IN ; Haverkamp, D
Link:	View record at Springer (Volltext)
Zeitschrift:	Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, Jg. 30 (2022-08-01), Heft 8, S. 2707-2713
Veröffentlichung:	2024- : [Hoboken] : Wiley ; <i>Original Publication</i>: [Heidelberg, Germany] : Springer International, c1993-, 2022
Medientyp:	academicJournal
ISSN:	1433-7347 (electronic)
DOI:	10.1007/s00167-021-06587-8
Schlagwort:	Humans Prosthesis Design Registries Reoperation adverse effects Retrospective Studies Survival Analysis Treatment Outcome Bone Cements Prosthesis Failure
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Knee Surg Sports Traumatol Arthrosc] 2022 Aug; Vol. 30 (8), pp. 2707-2713. <i>Date of Electronic Publication: </i>2021 May 02. MeSH Terms: Bone Cements* ; Prosthesis Failure* ; Humans ; Prosthesis Design ; Registries ; Reoperation / adverse effects ; Retrospective Studies ; Survival Analysis ; Treatment Outcome References: Abram SGF, Nicol F, Hullin MG, Spencer SJ (2013) The long-term outcome of uncemented low contact stress total knee replacement in patients with rheumatoid arthritis: results at a mean of 22 years. Bone Joint J 95B:1497–1499. (PMID: 10.1302/0301-620X.95B11.32257) ; Bagsby DT, Issa K, Smith LS, Elmallah RK, Mast LE, Harwin SF, Mont MA, Bhimani SJ, Malkani AL (2016) Cemented vs cementless total knee arthroplasty in morbidly obese patients. J Arthroplasty 31:1727–1731. 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Lower revision rates for cemented fixation in a long-term survival analysis of three different LCS designs.