dc.contributor.author | Niemeläinen, Mika J | |
dc.contributor.author | Mäkelä, Keijo T. | |
dc.contributor.author | Robertsson, Otto | |
dc.contributor.author | W-Dahl, Annette | |
dc.contributor.author | Furnes, Ove | |
dc.contributor.author | Fenstad, Anne Marie | |
dc.contributor.author | Pedersen, Alma B | |
dc.contributor.author | Schrøder, Henrik M. | |
dc.contributor.author | Reito, Aleksi | |
dc.contributor.author | Eskelinen, Antti | |
dc.date.accessioned | 2021-04-26T10:12:32Z | |
dc.date.available | 2021-04-26T10:12:32Z | |
dc.date.created | 2020-12-18T09:13:29Z | |
dc.date.issued | 2020 | |
dc.Published | Acta Orthopaedica. 2020, 91 (2), 184-190. | |
dc.identifier.issn | 1745-3674 | |
dc.identifier.uri | https://hdl.handle.net/11250/2739525 | |
dc.description.abstract | Background and purpose — Cemented fixation is regarded as the gold standard in total knee arthroplasty (TKA). Among working-age patients, there has been controversy regarding the optimal fixation method in TKA. To address this issue, we conducted a register-based study to assess the survivorship of cemented, uncemented, hybrid, and inverse hybrid TKAs in patients aged < 65 years.
Patients and methods — We used the Nordic Arthroplasty Register Association data of 115,177 unconstrained TKAs performed for patients aged < 65 years with primary knee osteoarthritis over 2000–2016. Kaplan–Meier (KM) survival analysis with 95% confidence intervals (CI) and Cox multiple-regression model with adjustment for age, sex, and nation were used to compare fixation methods in relation to revision for any reason.
Results — The 10-year KM survivorship of cemented TKAs was 93.6% (95% CI 93.4–93.8), uncemented 91.2% (CI 90.1–92.2), hybrid 93.0% (Cl 92.2–93.8), and inverse hybrid 96.0% (CI 94.1–98.1). In the Cox model, hybrid TKA showed decreased risk of revision after 6 years’ follow-up compared with the reference group (cemented) (hazard ratio [HR] 0.5 [CI 0.4–0.8]), while uncemented TKAs showed increased risk of revision both < 1 year (HR 1.4 [1.1–1.7]) and > 6 years’ (HR 1.3 [1.0–1.7]) follow-up compared to the reference.
Interpretation — Both cemented and hybrid TKAs had 10-year survival rates exceeding 92–>93% in patients aged < 65 years. Cemented TKA, however, was used in the vast majority (89%) of the operations in the current study. As it performs reliably in the hands of many, it still deserves the status of gold standard for TKA in working-age patients. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Taylor and Francis | en_US |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.title | The effect of fixation type on the survivorship of contemporary total knee arthroplasty in patients younger than 65 years of age: a register-based study of 115,177 knees in the Nordic Arthroplasty Register Association (NARA) 2000–2016 | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2020 The Author(s) | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.doi | 10.1080/17453674.2019.1710373 | |
dc.identifier.cristin | 1861366 | |
dc.source.journal | Acta Orthopaedica | en_US |
dc.source.40 | 91 | |
dc.source.14 | 2 | |
dc.source.pagenumber | 184-190 | en_US |
dc.identifier.citation | Acta Orthopaedica. 2020, 91 (2), 184–190. | en_US |
dc.source.volume | 91 | en_US |
dc.source.issue | 2 | en_US |