ArticleActa orthopaedica2021
Association between fixation type and revision risk in total knee arthroplasty patients aged 65 years and older: a cohort study of 265,877 patients from the Nordic Arthroplasty Register Association 2000-2016.
Article in Acta orthopaedica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- The effect of patient and prosthesis factors on revision rates after total knee replacement using a multi-registry meta-analytic approach.Acta orthopaedica · 2022Pooled it
- Assessment of improvement in functional outcomes between a novel knee replacement design and conventional designs in 240 patients: a randomized controlled trial.Acta orthopaedica · 2025Trial
- Global trends in fixation methods for primary total knee arthroplasty: An international registry-based analysis and review of outcomes.Journal of orthopaedics · 2025Article
- Enhanced improvement and comparable survivorship in cementless versus cemented total knee arthroplasty: a 2-year analysis of patient reported outcomes and 5-year analysis of implant survivorship.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- What Is the Survivorship of TKA With a Twin-peg or Spikes-and-keel Cementless Implant Compared With Cemented? A Registry-based Cohort Study.Clinical orthopaedics and related research · 2025Article
- The inclination of the tibial component has an impact on fracture stability in unicompartmental knee arthroplasty: an artificial bone study.Frontiers in bioengineering and biotechnology · 2025Article
- What are the age-related factors linked to aseptic revisions in constrained and unconstrained TKA as well as UKA? A register-based study from the German arthroplasty registry (EPRD).Archives of orthopaedic and trauma surgery · 2024Article
- Evidence for cemented TKA and THA based on a comparison of international register data.Orthopadie (Heidelberg, Germany) · 2024Review
- [Register data on cemented arthroplasty : A proof for cementless fixation?]Orthopadie (Heidelberg, Germany) · 2024Review
- Cemented vs. Cementless Fixation in Primary Knee Replacement: A Narrative Review.Materials (Basel, Switzerland) · 2024Review
- [The third-generation modern cementing technique in hip and knee arthroplasty].Orthopadie (Heidelberg, Germany) · 2023Review
- A TEN-YEAR FOLLOW-UP AFTER CEMENTLESS TOTAL KNEE ARTHROPLASTY IN COUNTY GENERAL HOSPITAL.Acta clinica Croatica · 2023Article
- The mid-term survival of cemented, uncemented, and hybrid fixation of the ACS mobile bearing total knee arthroplasty.Indian journal of orthopaedics · 2022Article
- Current Trends in Knee Arthroplasty: Are Italian Surgeons Doing What Is Expected?Medicina (Kaunas, Lithuania) · 2022Article
- No effect of fixation type on early and late mortality after total knee arthroplasty: a Dutch arthroplasty register study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Editorial: Different, yet strong together: the Nordic Arthroplasty Register Association (NARA).Acta orthopaedica · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 8 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - The population of the Nordic countries is aging and the number of elderly patients undergoing total knee arthroplasty (TKA) is also expected to increase. Reliable fixation methods are essential to avoid revisions. We compared the survival of different TKA fixation concepts with cemented fixation as the gold standard.Patients and methods - We used data from the Nordic Arthroplasty Register Association (NARA) database of 265,877 unconstrained TKAs performed for patients aged ≥ 65 years with primary knee osteoarthritis between 2000 and 2016. Kaplan-Meier (KM) survival analysis with 95% confidence intervals (CI) and the Cox multiple-regression model were used to compare the revision risk of the fixation methods.Results - Cemented fixation was used in 243,166 cases, uncemented in 8,000, hybrid (uncemented femur with cemented tibia) in 14,248, and inverse hybrid (cemented femur with uncemented tibia) fixation in 463 cases. The 10-year KM survivorship (95% CI) of cemented TKAs was 96% (96 - 97), uncemented 94% (94 - 95), hybrid 96% (96 - 96), and inverse hybrid 96% (94 - 99), respectively. Uncemented TKA was associated with increased risk of revision compared with the cemented TKA; the adjusted hazard ratio was 1.3 (95% CI 1.1 - 1.4).Interpretation - Cemented, hybrid, and inverse hybrid TKAs showed 10-year survival rates exceeding 95%. Uncemented fixation was associated with an increased risk of revision in comparison with cemented fixation. As both hybrid and inverse hybrid fixation were used in only a limited number of TKAs, indicating possibility of selection bias in their favor, cemented TKA still remains the gold standard, as it works reliably in the hands of many.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.