Survivorship of Primary NexGen Knee Replacement: Comparing Cementless Trabecular Metal to Other Designs of Tibial Component

Document Type

Article

Publication Date

9-2-2024

Publication Title

The journal of knee surgery

Abstract

PURPOSE: The impact of cementless trabecular metal (TM) implants on implant survivorship are not well delineated. This study compares primary total knee arthroplasty (TKA) revision rates of cemented knee replacements to two cementless knee replacement designs-cementless TM and another cementless design.

METHOD: Data from a national registry queried TKA procedures performed for osteoarthritis from 1999 to 2020. The risk of revision of Zimmer NexGen TKA using cementless TM, cementless non-TM, and cemented non-TM were compared. Analyses included Kaplan-Meier estimates of survivorship and Cox hazard ratios (HR), stratified by age and gender.

RESULTS: Cementless TM components had higher risks of revision compared to cementless non-TM implants (HR = 1.49; p = < 0.001). Cementless TM implants showed higher risks of revision compared to cemented non-TM prostheses for the first 2 years (HR = 1.75, p < 0.001). Non-TM prostheses posed equal risk of revision for cementless and cemented fixations (HR = 0.95, p = 0.522). Patients aged 55-64 years and 65-74 years had a higher risk of revision for cementless TM compared to cementless non-TM (HR = 1.40, p = 0.033 and HR = 1.79, p <0.001, respectively) and cemented non-TM implants (HR = 1.51, p < 0.001 and HR = 1.54, p <0.001, respectively).

CONCLUSION: The study shows there is an increased risk of revision with TM cementless implants for patients aged 55-74 years. These results do not support the use of TM tibial implants for patients of this age group for primary TKA.

PubMed ID

39084604

ePublication

ePub ahead of print

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