Randomised, prospective study comparing cemented and cementless total kneereplacement - Results of press-fit condylar total knee replacement at fiveyears

Early implants for total knee replacement were fixed to bone with cement. N o firm scientific reason has been given for the introduction of cementless knee replacement and the long-term survivorship of such implants has not sh own any advantage over cemented forms. In a randomised, prospective study w e have compared cemented and uncemented total knee replacement and report t he results of 139 prostheses at five years. Outcome was assessed both clini cally by independent examination using the Nottingham knee score and radiol ogically using the Knee Society scoring system. Independent statistical analysis of the data showed no significant differen ce between cemented and cementless fixation for pain, mobility or movement, There was no difference in the radiological alignment at five years, but t here was a notable disparity in the radiolucent line score. With cemented f ixation there was a significantly greater number of radiolucent lines on an teroposterior radiographs of the tibia and lateral radiographs of the femur . At five years, our clinical results would not support the use of the more e xpensive cementless fixation whereas the radiological results are of unknow n significance. Longer follow-up will determine any changes in the results and conclusions.