Acta Orthopaedica (Mar 2020)

The effect of fixation type on the survivorship of contemporary total knee arthroplasty in patients younger than 65 years of age: a register-based study of 115,177 knees in the Nordic Arthroplasty Register Association (NARA) 2000–2016

  • Mika J Niemeläinen,
  • Keijo T Mäkelä,
  • Otto Robertsson,
  • Annette W-Dahl,
  • Ove Furnes,
  • Anne M Fenstad,
  • Alma B Pedersen,
  • Henrik M Schrøder,
  • Aleksi Reito,
  • Antti Eskelinen

DOI
https://doi.org/10.1080/17453674.2019.1710373
Journal volume & issue
Vol. 91, no. 2
pp. 184 – 190

Abstract

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Background and purpose — Cemented fixation is regarded as the gold standard in total knee arthroplasty (TKA). Among working-age patients, there has been controversy regarding the optimal fixation method in TKA. To address this issue, we conducted a register-based study to assess the survivorship of cemented, uncemented, hybrid, and inverse hybrid TKAs in patients aged 6 years’ (HR 1.3 [1.0–1.7]) follow-up compared to the reference. Interpretation — Both cemented and hybrid TKAs had 10-year survival rates exceeding 92–>93% in patients aged < 65 years. Cemented TKA, however, was used in the vast majority (89%) of the operations in the current study. As it performs reliably in the hands of many, it still deserves the status of gold standard for TKA in working-age patients.