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  • Irmola, TeroUniversity of Tampere (author)

Association between fixation type and revision risk in total knee arthroplasty patients aged 65 years and older : a cohort study of 265,877 patients from the Nordic Arthroplasty Register Association 2000–2016

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • 2020-11-04
  • Medical Journals Sweden AB,2021

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:ca3d474f-aa1d-482c-863c-eb0714739c41
  • https://lup.lub.lu.se/record/ca3d474f-aa1d-482c-863c-eb0714739c41URI
  • https://doi.org/10.1080/17453674.2020.1837422DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Background and purpose — The population of the Nordic countries is aging and the number of elderly patients undergoing total knee arthroplasty (TKA) is also expected to increase. Reliable fixation methods are essential to avoid revisions. We compared the survival of different TKA fixation concepts with cemented fixation as the gold standard. Patients and methods — We used data from the Nordic Arthroplasty Register Association (NARA) database of 265,877 unconstrained TKAs performed for patients aged ≥ 65 years with primary knee osteoarthritis between 2000 and 2016. Kaplan–Meier (KM) survival analysis with 95% confidence intervals (CI) and the Cox multiple-regression model were used to compare the revision risk of the fixation methods. Results — Cemented fixation was used in 243,166 cases, uncemented in 8,000, hybrid (uncemented femur with cemented tibia) in 14,248, and inverse hybrid (cemented femur with uncemented tibia) fixation in 463 cases. The 10-year KM survivorship (95% CI) of cemented TKAs was 96% (96 − 97), uncemented 94% (94 − 95), hybrid 96% (96 − 96), and inverse hybrid 96% (94 − 99), respectively. Uncemented TKA was associated with increased risk of revision compared with the cemented TKA; the adjusted hazard ratio was 1.3 (95% CI 1.1 − 1.4). Interpretation — Cemented, hybrid, and inverse hybrid TKAs showed 10-year survival rates exceeding 95%. Uncemented fixation was associated with an increased risk of revision in comparison with cemented fixation. As both hybrid and inverse hybrid fixation were used in only a limited number of TKAs, indicating possibility of selection bias in their favor, cemented TKA still remains the gold standard, as it works reliably in the hands of many.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Ponkilainen, VilleUniversity of Tampere (author)
  • Mäkelä, Keijo T.Finnish National Institute for Health and Welfare,Turku University Hospital,The Finnish Arthroplasty Register,University of Turku (author)
  • Robertsson, OttoLund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Swedish Knee Arthroplasty Register(Swepub:lu)ort-otto (author)
  • W-Dahl, AnnetteLund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Swedish Knee Arthroplasty Register,Skåne University Hospital(Swepub:lu)ort-aw- (author)
  • Furnes, OveHaukeland University Hospital,University of Bergen,Norwegian Arthroplasty Register (author)
  • Fenstad, Anne M.Haukeland University Hospital,Norwegian Arthroplasty Register (author)
  • Pedersen, Alma B.Aarhus University Hospital,Danish Knee Arthroplasty Register (author)
  • Schrøder, Henrik M.Naestved Hospital (author)
  • Eskelinen, AnttiUniversity of Tampere (author)
  • Niemeläinen, Mika J.University of Tampere (author)
  • University of TampereFinnish National Institute for Health and Welfare (creator_code:org_t)

Related titles

  • In:Acta Orthopaedica: Medical Journals Sweden AB92:1, s. 91-961745-36741745-3682

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