CORR insights?: Trabecular metal in total knee arthroplasty associated with higher knee scores: A randomized controlled trial

摘要

Where Are We Now?: Despite the advantages for cementless tantalum fixation shown in the study by Fernandez-Fairen and colleagues, current evidence supports cemented fixation for TKA. The most valid evidence for the best mode of fixation can be collected in large multicenter or register studies that include all patients, or at least consecutive patients. Rand et al. [7] performed a survivorship analysis of more than 11,000 TKAs at 10 years. Results of the study showed a 92% survival rate with cemented implant fixation versus 61% with cementless implant fixation (p < 0.001). Gioe et al. [5] evaluated more than 5,700 TKAs for different modes of fixation and found that cementless fixation had the lowest survival rate compared to cemented fixation. In fact, to my knowledge, no multicenter or register studies in the literature favor cementless fixation when compared with cemented fixation. A recent meta-analysis of current randomized controlled trials and observational studies [4] tended to substantiate the findings in those larger registry studies, and found improved survival for cemented compared to cementless TKA.