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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 12, 1608-1614.
doi: 10.1302/0301-620X.89B12.19363  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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A randomised controlled trial of cemented versus cementless press-fit condylar total knee replacement

15-YEAR SURVIVAL ANALYSIS

P. N. Baker, MBBS, MRCS, MSc, Specialist Trainee in Trauma and Orthopaedics1; F. M. Khaw, MD, FRCS, Fellow of the Faculty of Public Health, Consultant in Health Protection, Honorary Clinical Senior Lecturer in Public Health Institute of Heath and Society2; L. M. G. Kirk, BSc, MCSP, Senior Research Physiotherapist3; C. N. A. Esler, BMedSci(Hons), FRCS(Tr & Orth), Consultant Orthopaedic Surgeon, Honorary Senior Lecturer4; and P. J. Gregg, MD, FRCS, FRCS(Ed), Consultant Orthopaedic Surgeon, Professor of Orthopaedic Surgical Science1

1 South Tees Hospitals NHS Trust, The James Cook University Hospital, Marton Road, Middlesbrough, Cleveland TS4 3BW, UK.
2 The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK.
3 Freeman Road Hospital, Freeman Road, High Heaton, Newcastle upon Tyne NE7 7DN, UK.
4 University Hospitals of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK.

Correspondence should be sent to Mr P. N. Baker; e-mail: drpnbaker{at}hotmail.com

We report the long-term survival of a prospective randomised consecutive series of 501 primary knee replacements using the press-fit condylar posterior cruciate ligament-retaining prosthesis. Patients received either cemented (219 patients, 277 implants) or cementless (177 patients, 224 implants) fixation. Altogether, 44 of 501 knees (8.8%) underwent revision surgery (24 cemented vs 20 cementless). For cemented knees the 15-year survival rate was 80.7% (95% confidence interval (CI) 71.5 to 87.4) and for cementless knees it was 75.3% (95% CI 63.5 to 84.3). There was no significant difference between the two groups (cemented vs cementless; hazard ratio (HR) 0.83, 95% CI 0.45 to 1.52, p = 0.55). When comparing the covariates there was no significant difference in the rates of survival between the side of operation (HR 0.58, p = 0.07), age (HR 0.97, p = 0.10) and diagnosis (HR 1.25 p = 0.72). However, there was a significant gender difference, with males having a higher failure rate with cemented fixation (HR 2.48, p = 0.004). Females had a similar failure rate in both groups.

This single-surgeon series, with no loss to follow-up, provides reliable data of the revision rates of one of the most commonly-used total knee replacements. The survival of the press-fit condylar total knee replacement remained good at 15 years, irrespective of the method of fixation.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General