SynthesisJournal of orthopaedic surgery and research2021
Long-term effects of cemented and cementless fixations of total knee arthroplasty: a meta-analysis and systematic review of randomized controlled trials.
Synthesis in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 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
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sensor-guided gap balance versus manual gap balance in primary total knee arthroplasty: a meta-analysis.Journal of orthopaedic surgery and research · 2022Pooled it
- Early Results of Unrestricted Kinematic Alignment in Cementless Total Knee Arthroplasty.Arthroplasty today · 2026Article
- Cementless total knee arthroplasty in post-traumatic or Post-ACL knees: A case series.Journal of clinical orthopaedics and trauma · 2025Article
- Global trends in fixation methods for primary total knee arthroplasty: An international registry-based analysis and review of outcomes.Journal of orthopaedics · 2025Article
- Advancements in Total Knee Arthroplasty over the Last Two Decades.Journal of clinical medicine · 2025Review
- The relationship between stress shielding, bone density changes and implant migration, failure and fracture after total knee arthroplasty: A systematic review.Journal of experimental orthopaedics · 2025Review
- Fixation in total knee arthroplasty: are cemented implants still mandatory in younger and obese patients?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Review
- Article
- Fixation options for total knee arthroplasty: a comprehensive literature review.Journal of orthopaedic surgery and research · 2024Review
- No component loosening of a cementless deep dish rotating platform knee at a 5-year follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Observational
- Fostering Excellence in Knee Arthroplasty: Developing Optimal Patient Care Pathways and Inspiring Knowledge Transfer of Advanced Surgical Techniques.Journal of healthcare leadership · 2023Article
- Article
- Dual-Energy CT-Based Bone Mineral Density Has Practical Value for Osteoporosis Screening around the Knee.Medicina (Kaunas, Lithuania) · 2022Article
- The role of hydroxyapatite coating in joint replacement surgery - Key considerations.Journal of clinical orthopaedics and trauma · 2022Review
- Epidural Anesthesia versus General Anesthesia for Total Knee Arthroplasty: Influences on Perioperative Cognitive Function and Deep Vein Thrombosis.Computational and mathematical methods in medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo determine the long-term effects (a minimum follow-up time 8.8 years) of cemented and cementless fixations used for total knee arthroplasty (TKA).
methodsPubMed, EMBASE, Ovid, Cochrane Library, CINAHL, China National Knowledge Infrastructure and China Wangfang database were interrogated for appropriate randomized controlled trials (RCTs) through July 2020. Data were extracted and assessed for accuracy by 2 of the authors acting independently. Any controversial discrepancies were resolved after discussion with a third author.
resultEight RCTs were included with low to moderate bias risks. The cemented fixation of TKA was comparable to cementless fixation in terms of implant survival (relative risk, 1.016; 95% CI 0.978 to 1.056; P = 0.417), Knee Society (KS) knee score (standardized mean difference (SMD), - 0.107; 95% CI - 0.259 to 0.045; P = 0.168), KS function score (SMD - 0.065; 95% CI - 0.238 to 0.109; P = 0.463), KS pain score (SMD - 0.300; 95% CI - 0.641 to 0.042; P = 0.085), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (SMD - 0.117; 95% CI - 0.307 to 0.073; P = 0.227), HSS score (SMD - 0.027; 95% CI - 0.270 to 0.217; P = 0.829), range of motion (SMD 0.061; 95% CI - 0.205 to 0.327; P = 0.652) at ≥ 8.8 years of follow-up. In terms of radiographic outcomes at ≥ 8.8 years of follow-up, the incidence of a radiolucent line in the cementless group was lower than for the cemented group (SMD 3.828; 95% CI 2.228 to 6.576; P < 0.001). However, the maximum total point motion (MTPM) of the cementless group was greater than for the cemented group (SMD - 0.739; 95% CI - 1.474 to - 0.005; P = 0.048).
conclusionsLong-term follow-up verified that cementless and cemented fixation have similar prosthesis survival rates, clinical scores and mobility. However, radiography suggested that each technique had an advantage with regard to the radiolucent line and MTPM.
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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.