Comparative outcomes of cemented versus cementless stems in bipolar hemiarthroplasty for femoral neck fractures.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors have no conflicts of interest to disclose. 10. J Arthroplasty. 2022 Apr;37(4):688-693.e1. doi: 10.1016/j.arth.2021.12.038. Epub 2022 Jan 3. Cemented Versus Cementless Total Knee Arthroplasty in Obese Patients With Body Mass Index ≥35 kg/m(2): A Contemporary Analysis of 812 Patients. Goh GS(1), Fillingham YA(1), Sutton RM(1), Small I(1), Courtney PM(1), Hozack WJ(1). Author information: (1)Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA. BACKGROUND: Cemented total knee arthroplasty (TKA) has been shown to have higher failure rates in obese patients, and cementless TKA may provide more durable fixation. This study compared outcomes and survivorship of obese patients undergoing cemented and cementless TKA of the same modern design. METHODS: We identified a consecutive series of 406 primary cementless TKA performed in obese patients with body mass index (BMI) ≥35 kg/m2 in 2013-2018. Each case was matched 1:1 with 406 cemented TKA based on age, sex, BMI, bearing surface, and year of surgery. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement and Short Form-12 were collected preoperatively, at 6 months and 2 years. Implant survivorship was recorded at mean 4.0 years (range 2.0-7.8). RESULTS: There was no difference in mean BMI between the cemented (38.6 ± 3.4 kg/m2; range, 35-60) and cementless cohorts (38.7 ± 3.3 kg/m2; range, 35-54; P = .706). Both groups had similar final postoperative scores and improvement in scores at 2 years. Furthermore, a similar percentage met the minimal clinically important difference (Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, 70.0% vs 71.2%, P = .700; Short Form-12 Physical, 74.1% vs 70.4%, P = .240). Both groups demonstrated high 7-year survivorship free from aseptic revision (99.0% vs 99.5%, P = .665). CONCLUSION: Obese patients with BMI ≥35 kg/m2 undergoing cementless and cemented TKA of the same modern design had similar outcomes and survivorship at early to mid-term follow-up. Continued surveillance of this high-risk population is necessary. Copyright © 2022 Elsevier Inc. All rights reserved. DOI: 10.1016/j.arth.2021.12.038