O1115 CEMENTED VS HAC AGC TKR. A PROSPECTIVE RANDOMISED CONTROLLED TRIAL

Abstract

Aims: The 98% 10 year survivorship of the cemented AGC TKR is regarded as gold standard.(1) The authors attributed their excellent results to the flat on flat design and the compression moulded polyethylene rather than the cement. The aim of this trial is to determine if the type of fixation also influences outcome. Method: Participants were randomly allocated to either a cemented or cementless hydroxyapatite coated AGC prosthesis. All patients were assessed with the Hospital for Special Surgery Score (HSS) and radiographs pre-operatively and then post-operatively at six weeks, six months, one year and annually. Results: 223 knees were studied with a mean follow up of 39 months (max 8 years) Both groups were well matched for age and sex. There were no significant differences between the two groups in post-operative HSS scores or in improvement of HSS scores. There has been no observable migration in either group. There were 15 radiolucenies (< 2mm) in the cemented and 1 in the HA group. A common finding in the HAC group was a radiodense line around the uncoated stem of the tibial prosthesis which is of no clinical significance. There has been 1 case requiring revision, which was from the HAC group. In addition 2 patella buttons were revised following traumatic separation. Conclusion: The early results are equally good for both groups with no significant difference in outcome or complication rate between cemented and HA coated fixation.