A randomised, controlled trial of cemented versus cementless press-fit condylar total knee replacement. Ten-year survival analysis

We have carried out a long‐term survival analysis of a prospective, randomised trial comparing cemented with cementless fixation of press‐fit condylar primary total knee replacements. A consecutive series of 501 replacements received either cemented (219 patients, 277 implants) or cementless (177 patients, 224 implants) fixation. The patients were contacted at a mean follow‐up of 7.4 years (2.7 to 13.0) to establish the rate of survival of the implant. The ten‐year survival was compared using life‐table and Cox's proportional hazard analysis. No patient was lost to follow‐up. The survival at ten years was 95.3% (95% CI 90.3 to 97.8) and 95.6% (95% CI 89.5 to 98.2) in the cemented and cementless groups, respectively. The hazard ratio for failure in cemented compared with cementless prostheses was 0.97 (95% CI 0.36 to 2.6). A comparison of the clinical outcome at ten years in 80 knees showed no difference between the two groups. The survival of the press‐fit condylar total knee replacement at ten years is good irrespective of the method of fixation and brings into question the use of more expensive cementless implants.