Similar patient-reported outcomes for hybrid and cemented stem fixation for aseptic tibial revision total knee arthroplasty: a comparison of sequential prospective cohorts

Abstract

Purpose The tibial stem fixation in an aseptic revision of total knee arthroplasty is poorly studied and controversial. The objective of this study was to prospectively compare clinical outcomes between hybrid and cemented fixation of the stem in aseptic tibial revision after a minimum follow-up of 5 years. Methods Two sequential prospective cohorts of patients who underwent aseptic tibial revision were compared after a minimum follow-up of five years: 31 had both tibial tray and stem cemented (cemented group), and 42 had a hybrid fixation with tibial tray cemented and stem cementless (hybrid group). Clinical assessment was performed by the Knee Society Scores and reduced Western Ontario and McMaster Universities Arthritis Index. Radiological assessment was also performed. Results There were no significant differences in preoperative data between groups. Postoperatively, no significant differences between groups in clinical scores or complication rate were found. Survival of the TKA revision at 5-year was 94% (95% CI 89–98%) in the cemented group, and 98% (95% CI 92–100%) in the hybrid group (ns). Conclusion Clinical outcomes and implant survival were comparable between hybrid and cemented tibial stem fixation. Level of evidence II.