Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Prospective insights into tibial stems, cemented versus uncemented in primary total knee arthroplasty: A dual-energy X-ray absorptiometry study.
Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Prospective insights into tibial stems, cemented versus uncemented in primary total knee arthroplasty: A dual-energy X-ray absorptiometry study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Trial
- A narrative review of clinical research on knee osteoarthritis in 2025.Annals of joint · 2026Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeThe durability and effectiveness of total knee arthroplasty (TKA) depend on secure implant fixation and efficient bone integration. While cemented tibial components provide immediate mechanical stability, the addition of a short stem may be indicated in selected cases to enhance fixation. However, the stem does not allow for biological integration. The advantages of cementation over press-fit fixation remain a subject of debate, particularly regarding their impact on periprosthetic bone mineral density (BMD) over time. This study aims to compare periprosthetic BMD changes between cemented and noncemented tibial stems in primary TKA.
methodsIn this prospective, monocentric study, we compared periprosthetic BMD changes in 60 patients undergoing primary TKA, randomised into two groups: 30 with cemented and 30 with noncemented tibial stems. Dual-energy X-ray absorptiometry (DEXA) measured BMD preoperatively and at 3, 6, 12 and 24 months postoperatively across six zones: beneath the tibial tray (R1, R2), around the stem (R3, R4), at the apex (R5), and a control zone below the stem (R6). Statistical analyses included repeated measures analysis of variance and independent t-tests.
resultsCemented stems showed a significant increase in BMD at 12 months (+0.10 g/cm², p = 0.03) and 24 months (+0.12 g/cm², p = 0.04), outperforming noncemented stems (+0.06 g/cm², p = 0.12). Overall, cemented stems demonstrated greater BMD gains (+0.15 g/cm² vs. +0.08 g/cm², p = 0.03). Minimal changes were observed in both groups, with cemented stems showing slightly higher BMD retention (+0.05 g/cm² vs. -0.02 g/cm², p = 0.09). No statistically significant differences were recorded in certain regions.
conclusionCemented stems demonstrated greater periprosthetic BMD retention, which may contribute to improved mechanical environment for the implant. These findings may help guide the selection of fixation methods in primary TKA, particularly for patients with compromised bone quality. LEVEL OF EVIDENCE: Level I.
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