Young and heavy patients with a cementless TKA do as well as older and lightweight patients

Given concerns about long term implant loosening in young, heavy patients, we asked whether these patients would fare as well as older, lightweight patients with bone-ingrowth fixation. Cementless total knee arthroplasty was performed consecutively in 1328 patients (1556 knees) using a total knee system designed for porous-ingrowth fixation. A consecutive series of 122 patients (167 knees) whose age was younger than 55 years and whose weight was greater than 90 kg was compared with a gender-matched consecutive series of 122 patients (167 knees) who were 65 years of age or older and who weighed less than 80 kg. The minimum followup was 5 years (mean 7.3 years; range 5-10 years). The mean Knee Society scores and pain scores were similar at each interval for both groups. Function scores were better for the young, heavy patients at each interval. None of the knees in either group loosened. One patient in the young, heavy group underwent polyethylene component revision for wear. These results indicate young, heavy patients fare as well as older, lightweight patients when this implant is used with the osteointegration technique.

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.