Finally , with use of a variety of vali date d measures , there was no difference between the two groups in terms of functional status at two , eight , and ten years , regardless of the measure used .
A less expensive all-polyethylene component as part of a total knee arthroplasty has results equivalent to those obtained with a cemented metal-backed tibial component .
BACKGROUND The cost of the implant as part of a total knee arthroplasty accounts for a substantial portion of the costs for the overall procedure : all-polyethylene tibial components cost considerably less than cemented metal-backed tibial components .
We performed a systematic review of the literature to determine whether the clinical results of lower-cost all-polyethylene tibial components were comparable with the results of a more expensive metal-backed tibial component .
Hydroxyapatite-coated tibial implants compared with cemented tibial fixation in primary total knee arthroplasty. A randomized trial of outcomes at five years.
BACKGROUND Although excellent long-term results have been reported with cemented tibial fixation , cementless fixation as a means to improve the longevity of total knee prostheses continues to be of interest to clinicians . The purpose of this study was to compare outcomes between cementless tibial fixation with hydroxyapatite and cemented tibial fixation in the first five years following primary total knee arthroplasty . METHODS We performed a prospect i ve , r and omized clinical trial that included eighty-one patients with noninflammatory knee arthritis who underwent primary total knee arthroplasty when they were less than seventy years of age . The subjects were r and omized at the time of surgery to be treated with either cementless tibial fixation with hydroxyapatite or cemented tibial fixation . Evaluations were performed preoperatively and at six months , one year , and five years postoperatively by a physical therapist who was blinded to group allocation . Self-reported pain and function , the primary outcomes , were measured with the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) and the R AND 36-Item Health Survey ( R AND -36 ) . Complications and revision rates were determined through a review of hospital records and at each patient evaluation . The Knee Society radiographic score was used to evaluate plain radiographs at each assessment . RESULTS Seventy subjects ( 86 % ) completed the five-year assessment . Slightly more pain was reported in the hydroxyapatite group at six months as measured with both the WOMAC and the R AND -36 , a difference that disappeared by one year postoperatively . No differences were seen in function , radiographic findings , or complications . No subject required revision of the tibial prosthesis during the study . CONCLUSIONS At five years postoperatively , there is no difference between cementless tibial fixation with hydroxyapatite and cemented tibial fixation in terms of self-reported pain , function , health-related quality of life , postoperative complications , or radiographic scores
Finally , with use of a variety of vali date d measures , there was no difference between the two groups in terms of functional status at two , eight , and ten years , regardless of the measure used .
A less expensive all-polyethylene component as part of a total knee arthroplasty has results equivalent to those obtained with a cemented metal-backed tibial component .
BACKGROUND The cost of the implant as part of a total knee arthroplasty accounts for a substantial portion of the costs for the overall procedure : all-polyethylene tibial components cost considerably less than cemented metal-backed tibial components .
We performed a systematic review of the literature to determine whether the clinical results of lower-cost all-polyethylene tibial components were comparable with the results of a more expensive metal-backed tibial component .