PMID- 34781394 OWN - NLM STAT- MEDLINE DCOM- 20230331 LR - 20230331 IS - 1938-2480 (Electronic) IS - 1538-8506 (Linking) VI - 36 IP - 5 DP - 2023 Apr TI - Similar Healthcare Utilization and 1-Year Patient-Reported Outcomes between Cemented and Cementless Primary Total Knee Arthroplasty: A Propensity Score-Matched Analysis. PG - 530-539 LID - 10.1055/s-0041-1739201 [doi] AB - Cementless fixation for total knee arthroplasty (TKA) has gained traction with the advent of newer fixation technologies. This study assessed (1) healthcare utilization (length of stay (LOS), nonhome discharge, 90-day readmission, and 1-year reoperation); (2) 1-year mortality; and (3) 1-year joint-specific and global health-related patient-reported outcome measures (PROMs) among patients who received cementless versus cemented TKA. Patients who underwent cementless and cemented TKA at a single institution (July 2015-August 2018) were prospectively enrolled. A total of 424 cementless and 5,274 cemented TKAs were included. The cementless cohort was propensity score-matched to a group cemented TKAs (1:3-cementless: n = 424; cemented: n = 1,272). Within the matched cohorts, 76.9% (n = 326) cementless and 75.9% (n = 966) cementless TKAs completed 1-year PROMs. Healthcare utilization measures, mortality and the median 1-year change in knee injury and osteoarthritis outcome score (KOOS)-pain, KOOS-physical function short form (PS), KOOS-knee related quality of life (KRQOL), Veteran Rand (VR)-12 mental composite (MCS), and physical composite (PCS) scores were compared. The minimal clinically important difference (MCID) for PROMs was calculated. Cementless TKA exhibited similar rates of median LOS (p = 0.109), nonhome discharge disposition (p = 0.056), all-cause 90-day readmission (p = 0.226), 1-year reoperation (p = 0.597), and 1-year mortality (p = 0.861) when compared with cemented TKA. There was no significant difference in the median 1-year improvement in KOOS-pain (p = 0.370), KOOS-PS (p = 0.417), KOOS-KRQOL (p = 0.101), VR-12-PCS (p = 0.269), and VR-12-MCS (p = 0.191) between the cementless and cemented TKA cohorts. Rates of attaining MCID were similar in both cohorts for assessed PROMs (p > 0.05, each) except KOOS-KRQOL (cementless: n = 313 (96.0%) vs. cemented: n = 895 [92.7%]; p = 0.036). Cementless TKA provides similar healthcare-utilization, mortality, and 1-year PROM improvement versus cemented TKA. Cementless fixation in TKA may provide value through higher MCID improvement in quality of life. Future episode-of-care cost-analyses and longer-term survivorship investigations are warranted. CI - Thieme. All rights reserved. FAU - Erossy, Michael P AU - Erossy MP AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Emara, Ahmed K AU - Emara AK AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Rothfusz, Christopher A AU - Rothfusz CA AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Klika, Alison K AU - Klika AK AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Bloomfield, Michael R AU - Bloomfield MR AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Higuera, Carlos A AU - Higuera CA AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Jin, Yuxuan AU - Jin Y AD - Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio. FAU - Krebs, Viktor E AU - Krebs VE AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Mesko, Nathan W AU - Mesko NW AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Molloy, Robert M AU - Molloy RM AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Murray, Trevor G AU - Murray TG AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Patel, Preetesh D AU - Patel PD AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Stearns, Kim L AU - Stearns KL AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Schaffer, Jonathan L AU - Schaffer JL AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Strnad, Gregory J AU - Strnad GJ AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. FAU - Piuzzi, Nicolas S AU - Piuzzi NS AUID- ORCID: 0000-0003-3007-7538 AD - Cleveland Clinic Foundation, Orthopedic & Rheumatologic Institute, Cleveland, Ohio. LA - eng PT - Journal Article DEP - 20211115 PL - Germany TA - J Knee Surg JT - The journal of knee surgery JID - 101137599 RN - 0 (Bone Cements) SB - IM MH - Humans MH - *Arthroplasty, Replacement, Knee MH - *Knee Prosthesis MH - Propensity Score MH - Quality of Life MH - Bone Cements/therapeutic use MH - Patient Acceptance of Health Care MH - Patient Reported Outcome Measures MH - Pain MH - Treatment Outcome COIS- C.A.H. reports grants from Stryker, grants and personal fees from KCI, grants from Ferring Pharmaceuticals, grants from CD Diagnostics, grants from OREF, grants from Orthofix, grants from Lyfstone, grants from Zimmer Biomet, outside the submitted work. N.W.M. reports personal fees from Stryker Orthopaedics, personal fees from KCI Acelity, personal fees from Bone Support, outside the submitted work. T.G.M. reports personal fees from Zimmer Biomet, outside the submitted work. P.D.P. reports personal fees from Stryker, personal fees from Zimmer-Biomet, outside the submitted work. N.S.P. reports other from ISCT, other from Orthopaedic Research Society, other from Zimmer, outside the submitted work. G.J.S. reports other from Oberd, during the conduct of the study. Rest of the authors do not report any conflicts of interests. EDAT- 2021/11/16 06:00 MHDA- 2023/03/31 06:42 CRDT- 2021/11/15 20:32 PHST- 2023/03/31 06:42 [medline] PHST- 2021/11/16 06:00 [pubmed] PHST- 2021/11/15 20:32 [entrez] AID - 10.1055/s-0041-1739201 [doi] PST - ppublish SO - J Knee Surg. 2023 Apr;36(5):530-539. doi: 10.1055/s-0041-1739201. Epub 2021 Nov 15.