Purpose: Unicompartmental Knee Replacements (UKR) are being performed in patients with increasing demands and life expectancies with surgical concerns that cemented fixation will not last. Cementless fixation may offer a solution, but the results in different age groups have not been assessed. The effect of age at surgery on the outcomes of cementless UKRs was investigated.
Methods: A prospective cohort of 1000 medial cementless mobile bearing UKR were analysed. Patients were categorised into four age groups (< 55, 55 to < 65, 65 to < 75 and ≥ 75 years). Implant survival was assessed using endpoints reoperation, revision and major revision requiring revision knee replacement components. Functional outcomes were assessed.
Results: 10 year cumulative revision rate for the < 55, 55 to < 65, 65 to < 75 and ≥ 75 groups were 2.1% (CI 0.6-6.1), 1.8% (CI 0.6-5.3), 3.2% (CI 1.5-6.5) and 4.1% (1.7-9.6) with no differences between groups (p = 0.52). Two of the 22 revisions were considered major. The 10 year cumulative reoperation rates were 4.5% (CI 2.0-10.0), 3.0% (CI 1.3-6.5), 3.8% (CI 2.0-7.1) and 4.1% (CI 1.7-9.6) with no differences between groups (p = 0.81). The 10 year median Oxford Knee Scores were 42.5, 46.5, 45 and 42.5, respectively. The 10 year median Objective American Knee Society Scores were 95 for all age groups.
Conclusion: The cementless mobile bearing UKR has low reoperation and revision rates and similar functional outcomes in all age groups. Cementless UKR should be used in all age groups and age should not be considered a contraindication.
Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00167-020-06428-0 | DOI Listing |
Arthroplast Today
February 2025
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Background: Improvements in cementless total hip arthroplasty have been directed at optimizing osseointegration of the femoral implant to reduce aseptic loosening rates. Stem design plays a critical role in the performance of these implants. Given the increase in new stem designs and the creation of an updated classification system, improved understanding of the outcomes of each stem type is warranted.
View Article and Find Full Text PDFJ Exp Orthop
January 2025
Department of Orthopaedic Surgery and Traumatology Città della Salute e della Scienza Turin Italy.
Purpose: This systematic review and meta-analysis aimed to compare the clinical and radiological outcomes of patients undergoing revision total knee arthroplasty (rTKA) using uncemented press-fit stems (hybrid fixation) versus cemented stems (cemented fixation). It is also examined whether cemented fixation offers any superiority over hybrid fixation regarding implant survival, clinical function, imaging analysis and complication rates.
Methods: Following the PRISMA guidelines, a systematic review and meta-analysis were conducted on five databases (Pubmed, Scopus, Embase, Medline and Cochrane).
Shoulder Elbow
January 2025
Orthopaedic and Trauma Surgery Department, Hospital de Terrassa, Terrassa, Barcelona, Spain.
Objectives: To evaluate the clinical significance of stress shielding in patients who have undergone an uncemented reverse shoulder arthroplasty (RSA) with a proximally coated stem for complex proximal humeral fractures (PHF) comprising 3 or 4 parts, assessed at 2 years postoperatively. Additionally, this study aims to examine the correlation between tuberosity healing and clinical outcomes.
Methods: Single Centre.
J Clin Med
December 2024
Department of Orthopedic Surgery, Ordensklinikum Linz Barmherzige Schwestern, Vinzenzgruppe Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria.
Short-stem total hip arthroplasty (THA) has gained popularity due to its bone-sparing technique, but its outcomes in patients with obesity remain uncertain. The aim of this study was to investigate the impact of obesity on postoperative subsidence and clinical outcomes after short-stem THA. A retrospective cohort study with a minimum follow-up of 24 months was conducted on 163 patients who underwent short-stem THA with a collarless, triple-tapered, cementless stem achieving fixation in the metaphyseal region.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
January 2025
Department of Orthopedic Surgery, Auckland City Hospital, Grafton, Auckland, New Zealand.
Hypothesis And Background: As the incidence of reverse total shoulder arthroplasty (RTSA) continues to rise, better understanding of the long-term risks and complications is necessary to determine the best choice of implant. The majority (75%) of RTSA performed in New Zealand use either SMR (Systema Multiplana Randelli, Lima-LTO, Italy) or Delta Xtend (DePuy Synthes, USA). The aim of this registry-based study was to compare implant survival, risk of revision and reasons for revision between the two most frequently used RTSA prostheses: SMR and Delta Xtend.
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