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- Talk
- 22/09/2022
- UK
Investigating Primary and Long-Term Fixation of the Oxford Unicompartmental Knee Replacement Tibial Component: Ten-Year Results of a Randomised Controlled Trial Comparing Cemented and Cementless Fixation Using Radiostereometric Analysis
Description
In this presentation, medical student Lachlan Arthur discusses the primary and long-term fixation of the Oxford uni knee prosthesis, with a focus on the tibial component. He presents results from a randomized controlled trial (RCT) comparing cemented and cementless fixation over a 10-year span. Lachlan begins by introducing the concept of cementless fixation as an alternative to traditional cemented methods, highlighting findings from prior research that indicated initial instability in cementless components within two years post-surgery.
The study aimed to assess the long-term performance of these fixation methods using radial stereometric analysis (RSA), recognized as the gold standard for measuring orthopedic implant migration. The study included 47 patients randomized to receive either cemented or cementless components; by the 10-year mark, 13 cemented and 16 cementless knees were available for analysis.
Lachlan details the methodology, including the collection of weight-bearing stereoradiographs and the analysis employed to evaluate the maximum total point motion (MTPM) and component migrations in three dimensions. Results found that cementless components showed significant subsidence and greater MTPM during the first six months compared to cemented components, although both showed stable fixation beyond this period.
He notes that while initial migration was higher for cementless components, once primary fixation is achieved, they demonstrate stable long-term performance. Clinically, no significant differences were found in Oxford knee scores between the two groups. The presentation concludes that cementless tibial components may have better outcomes in terms of lower rates of radiolucent lines and overall stability, which could contribute to less need for revision surgeries.
The session ends with an acknowledgment of applause from the audience.