This is a single-surgeon randomised controlled trial comparing cemented versus cementless fixation of the press-fit condylar posterior cruciate-retaining total knee replacement. It reports 15-year implant survival using revision of any original component as the endpoint. The design featured intraoperative randomisation after bone preparation and zero loss to follow-up.
When you counsel a patient on cemented versus cementless TKR, this trial tells you the fixation method alone does not determine 15-year survival for a modern PCL-retaining implant.
The strength here is the design: single surgeon, intraoperative randomisation only after confirming both methods were suitable, and zero loss to follow-up. That last point matters because incomplete follow-up inflates apparent survival, which is why this trial's numbers look lower than some registry-style reports.
The one signal worth remembering is gender: males failed more often with cemented fixation, females did not. The authors offer no mechanism, so treat this as a hypothesis, not a mandate.
Also high-yield is the shift in failure mode over time. Infection dominated early revisions, but aseptic loosening became the leading cause by 15 years. When you see a failing TKA years out, loosening is the mode to expect.
This is a single-surgeon randomised controlled trial comparing cemented versus cementless fixation of the press-fit condylar posterior cruciate-retaining total knee replacement. It reports 15-year implant survival using revision of any original component as the endpoint. The design featured intraoperative randomisation after bone preparation and zero loss to follow-up.
When you counsel a patient on cemented versus cementless TKR, this trial tells you the fixation method alone does not determine 15-year survival for a modern PCL-retaining implant.
The strength here is the design: single surgeon, intraoperative randomisation only after confirming both methods were suitable, and zero loss to follow-up. That last point matters because incomplete follow-up inflates apparent survival, which is why this trial's numbers look lower than some registry-style reports.
The one signal worth remembering is gender: males failed more often with cemented fixation, females did not. The authors offer no mechanism, so treat this as a hypothesis, not a mandate.
Also high-yield is the shift in failure mode over time. Infection dominated early revisions, but aseptic loosening became the leading cause by 15 years. When you see a failing TKA years out, loosening is the mode to expect.