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General Orthopaedics

THE CEMENTLESS UNI: COMING TO YOUR HOSPITAL SOON?

Current Concepts in Joint Replacement (CCJR) – Winter 2012



Abstract

Unicompartmental Knee Replacement (UKR) is associated with fewer complications, faster recovery and better function than Total Knee Replacement (TKR). However, joint registers demonstrate a higher revision rate, which limit their use. Common reasons for revision include aseptic loosening and pain. Currently most UKRs are cemented; Cementless UKR was introduced to address these problems. In a randomised trial cementless fixation was found to have similar outcome scores but fewer radiolucencies than cemented fixation. It was also quicker and simpler. In a large multicentre cohort study in the hands of experienced surgeons it was found that following cementless UKR the incidence of complications was similar to cemented and there were no additional contra-indications. There were also no complete radiolucencies, which are common after cemented fixation. These studies demonstrate that cementless UKR are safe and effective and achieve better fixation with fewer radiolucencies than cemented UKR. They therefor suggest that cemented fixation should decrease the incidence of revision for aseptic loosening and for pain associated with radiolucency, and as a result the revision rate of UKR in the joint registers should decrease. Preliminary data from the registries demonstrates that this is happening.