Back to Search Start Over

Osteoporosis May Not Be an Absolute Contraindication for Cementless Total Knee Arthroplasty.

Authors :
Xu JJ
Magruder ML
Lama G
Vakharia RM
Tabbaa A
Wong JCH
Source :
The Journal of arthroplasty [J Arthroplasty] 2024 Oct 16. Date of Electronic Publication: 2024 Oct 16.
Publication Year :
2024
Publisher :
Ahead of Print

Abstract

Background: Cementless total knee arthroplasty (TKA) has received growing interest, particularly in younger populations, due to potential long-term survivability and improved bone preservation. Poor bone stock, as seen in osteoporosis, is considered a contraindication for this technique. This study evaluated whether osteoporotic patients < 75 years undergoing cementless TKA demonstrate similar: 1) implant-related complications, 2) medical complications, 3) readmission rates, and 4) 3-year implant survivability.<br />Methods: A retrospective query of a national administrative claims database was performed between 2010 and 2022 for patients less than or equal to 75 years old who have osteoporosis and underwent primary TKA. Osteoporotic patients were divided into cementless and cemented cohorts, and propensity scores were matched based on age, sex, obesity, and the Charlson Comorbidity Index. Matching produced 7,923 patients (1,321 uncemented, 6,602 cemented). Multivariate logistic regressions evaluated the following outcomes: 90-day and 2-year implant-related complications, 90-day postoperative medical complications, and 90-day readmissions. Kaplan-Meier survival analysis was conducted to assess 3-year all-cause revision implant survivability. The significance threshold was set to P < 0.01 to minimize type 1 bias.<br />Results: There were no statistically significant differences in implant-related complications, medical complications, readmissions, and lengths of stay between cementless and cemented TKA groups. Kaplan-Meier analysis demonstrated statistically similar 3-year survivability between cohorts (cemented: 97.6%, confidence interval 96.6 to 98.5; cementless: 97.2%, confidence interval 96.7 to 97.7; P = 0.472).<br />Conclusions: Patients who have osteoporosis have equivalent medical and implant-related complications as well as 3-year implant survival following cementless TKA compared with a cemented technique. Our results support cementless TKA as a viable option for patients < 75 years, regardless of prior diagnosis of osteoporosis. Intraoperative decisions regarding bone quality are still necessary to discriminate between those who are candidates for cementless TKA with those who are not.<br />Level of Evidence: Level III, Retrospective cohort study.<br /> (Copyright © 2024 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1532-8406
Database :
MEDLINE
Journal :
The Journal of arthroplasty
Publication Type :
Academic Journal
Accession number :
39419420
Full Text :
https://doi.org/10.1016/j.arth.2024.10.011