Cemented versus cementless fixation in total knee arthroplasty

The question of whether to use cemented or cement-less fixation for a total knee arthroplasty (TKA) is still debated. Discouraging preliminary results of cement-less TKAs have determined the worldwide use of cemented implants. However, with the development of biotechnologies and new biomaterials with high osteoconductive properties, biological fixation is now becoming an attractive option for improving the longevity of TKAs, especially in young patients. There is no evidence in the current literature to support the use of one method of fixation. The extensive clinical experience with cemented implants gathered over the years justifies their widespread use. New randomized clinical trials are necessary to compare cementless fixation based on the new ingrowth surfaces with standard cemented implants.