Comparative study of fixation mode in total knee arthroplasty with preservation of the posterior cruciate ligament

Purpose of the study We performed a prospective randomized study to compare two fixation modes, with and without cement, for total knee arthroplasty. Material and methods The study series was composed of 96 cemented or noncemented total knee arth roplasties performed between May 1993 and October 1995. The only difference was the diamond interface used for cemented prostheses and the mesh interf ace used for uncemented prostheses. The operator was unaware of the type of fixation until the bone slices had been obtained. We assessed outcome in 7 3 cases with a mean follow-up of 27 months. The two populations were compar able for preoperative clinical status, bone tophicity and surgical procedur e. Results The mean duration of the operation was significantly longer (> 10 min) for the cemented protheses. The complication rates were comparable but we did h ave two mobilizations of the tibial implant in the noncemented group. The t otal scores (127 +/- 29 in the cemented group versus 135 +/- 20 in the unce mented group) were significantly different. There were however more cases w ith degradation of the controlateral knee in the cemented group although th e difference was not significant. When these cases were excluded from the a nalysis, the total scores for two groups were similar (143 and 140 respecti vely). Radiographic outcome was quite different with mobilization of the ti bial implant in 2 cases and the rate of lucent borders was significantly hi gher in the noncemented group. Discussion and conclusion While the clinical outcome was comparable, the quality of the fixation was significantly better with cemented arthroplasty, which remains the gold sta ndard.