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The Case for Cementless Total Knee Arthroplasty.

Peter Aaron Gold1, Luke Garbarino1, Nipun Sodhi1

  • 1Department of Orthopaedic Surgery, Long Island Jewish Medical Center, Northwell Health, New York, New York.

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Summary

Modern cementless total knee arthroplasty (TKA) designs show promising long-term survivorship. This review highlights their potential advantages over traditional cemented fixation for active patients.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Arthroplasty Research

Background:

  • Patient demographics for total knee arthroplasty (TKA) are shifting towards younger, more active, and obese individuals.
  • This demographic shift necessitates implants with enhanced longevity and reliable long-term fixation.
  • Historically, cemented fixation has been the standard, but early cementless designs faced challenges with implant ingrowth.

Purpose of the Study:

  • To review and analyze longer-term survivorship data for contemporary cementless TKA systems.
  • To address the persistent perception of cementless TKA being inferior to cemented TKA.
  • To evaluate the impact of modern implant design on cementless TKA outcomes.

Main Methods:

  • Literature review focusing on longer-term survivorship data of recent cementless TKA systems.
  • Analysis of studies comparing cementless and cemented TKA outcomes.
  • Examination of factors influencing cementless fixation, particularly implant design.

Main Results:

  • Recent advances in cementless TKA design have addressed previous limitations related to implant ingrowth.
  • Longer-term survivorship data for modern cementless TKA systems demonstrate significant potential.
  • Evidence suggests cementless fixation can achieve favorable outcomes, challenging historical perceptions.

Conclusions:

  • Modern cementless TKA designs are overcoming initial challenges and show comparable or superior long-term survivorship.
  • Implant design is a critical factor in the success of cementless total knee arthroplasty.
  • Cementless fixation presents a viable and potentially advantageous option for the evolving TKA patient population.