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Cementless total knee replacement fixation: a contemporary durable solution--affirms.

L M Kwong1, E S Nielsen1, D R Ruiz1

  • 1Department of Radiology, Harbor-UCLA Medical Center, 1000 W. Carson Street, Box 422, Torrance, California, 90509, USA.

The Bone & Joint Journal
|November 9, 2014
PubMed
Summary

Cementless total knee replacement (TKR) using porous tantalum implants demonstrated excellent outcomes in a trainee-led study. High implant survival and patient satisfaction were observed at seven-year follow-up.

Keywords:
Cementlessmonoblock patellaporous tantalumtibiatotal knee replacement

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Medical Device Technology

Background:

  • Total knee replacement (TKR) is a common procedure for end-stage knee arthritis.
  • Cementless fixation with porous tantalum implants is an emerging technique.
  • Evaluating outcomes of TKR performed by surgical trainees is crucial for surgical education.

Purpose of the Study:

  • To assess the clinical and radiological outcomes of primary cementless total knee replacement (TKR) utilizing porous tantalum implants.
  • To evaluate the performance of these implants when placed by surgical trainees.

Main Methods:

  • Retrospective review of 115 primary cementless TKRs performed by surgical trainees.
  • Implants included porous tantalum monoblock tibial and patellar components, and posterior stabilized (PS) cobalt-chromium femoral components.
  • Clinical and radiological follow-up at a mean of 7 years, assessing implant positioning, alignment, radiolucencies, lysis, loosening, and patient satisfaction.

Main Results:

  • 95.7% implant survival rate with no radiological evidence of loosening or osteolysis.
  • No revisions were required due to aseptic loosening.
  • Good component alignment and patellar tilt were achieved; 91% patient satisfaction with pain improvement.

Conclusions:

  • Cementless total knee replacement using porous tantalum implants demonstrates favorable clinical and radiological outcomes.
  • These results suggest that porous tantalum TKR is a viable option even when performed by surgical trainees.
  • The technique yields durable results with high patient satisfaction at medium-term follow-up.