Cementless Compared to Cemented Total Knee Arthroplasty is Associated With More Revisions Within 1 Year of Index Surgery

Daniel Chiou, MD; Alan K. Li, BS; Alexander Upfill-Brown, MD; Armin Arshi, MD; Peter Hsiue, MD; Kevin Chen, BA; Alexandra Stavrakis, MD; Christos Demetris Photopoulos, MD

Arthroplasty Today (Jun 2023)

Cementless Compared to Cemented Total Knee Arthroplasty is Associated With More Revisions Within 1 Year of Index Surgery

Daniel Chiou, MD,
Alan K. Li, BS,
Alexander Upfill-Brown, MD,
Armin Arshi, MD,
Peter Hsiue, MD,
Kevin Chen, BA,
Alexandra Stavrakis, MD,
Christos Demetris Photopoulos, MD

Affiliations

Daniel Chiou, MD: Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA; Corresponding author. Department of Orthopaedic Surgery, University of California, 1225 15th Street, Suite 2100, Santa Monica, CA 90404, USA. Tel.: +1 424 325 9543.
Alan K. Li, BS: Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA
Alexander Upfill-Brown, MD: Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA
Armin Arshi, MD: Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA
Peter Hsiue, MD: Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA
Kevin Chen, BA: Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA
Alexandra Stavrakis, MD: Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA
Christos Demetris Photopoulos, MD: Kerlan-Jobe Orthopaedic Institute, Los Angeles, CA, USA

Journal volume & issue: Vol. 21
p. 101122

Abstract

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Background: Cementless total knee arthroplasties (TKAs) have gained renewed interest due to improved implant designs and lower rates of revision than its cemented counterparts. The purpose of this study was to compare revision rates between cemented vs cementless TKAs within 1 year of primary arthroplasty. Methods: This was a retrospective review from the PearlDiver Patient Record Database. International Classification of Diseases and Current Procedural Terminology codes were used to identify patients who had undergone cemented and cementless TKAs and subsequent surgical revisions. An unadjusted univariate analysis of patient demographics, Charlson Comorbidity Index score, and surgical revisions at 90 days and 1 year after TKA was performed using chi-squared testing. Multivariate logistic regression analyses were subsequently performed for 1-year surgical complications requiring revision. Results: Of 324,508 patients, 312,988 (96.45%) underwent cemented TKAs, and 11,520 (3.55%) underwent cementless TKAs. Patients undergoing cementless TKA tended to be younger than patients undergoing cemented TKA (63.67 ± 9.15 cementless vs 66.22 ± 8.85 cemented, P < .001). Univariate chi-squared testing showed that cementless patients were more likely to require 1-component femoral or tibial revision at 90 days and 1 year, irrigation and debridement at 90 days and 1 year, and arthroscopy with lysis of adhesions at 1 year only. Similar findings were observed for these 3 revision procedures at 1 year after correcting for age, gender, and Charlson Comorbidity Index score using multivariate logistic regression analysis as cementless TKA patients had higher odds ratios for each of the revisions. Conclusions: Small but significant differences were found in surgical revisions among cementless TKAs when compared to cemented TKAs within 1 year of the index procedure.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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