Current Evidence-based Indications for Modern Noncemented Total Knee Arthroplasty

Area of Science:

• Orthopaedic Surgery
• Biomaterials Science
• Implant Technology

Background:

• Total knee arthroplasty (TKA) is a common orthopaedic procedure.
• Traditionally, cemented implants using polymethyl methacrylate are standard for fixation.
• Noncemented implants are gaining traction due to potential long-term stability, particularly in younger patients.

Purpose of the Study:

• To review the evolving role and considerations of noncemented total knee arthroplasty.
• To highlight the advantages and limitations of uncemented TKA designs.
• To inform surgeons about the latest developments in noncemented TKA.

Main Methods:

• Review of current literature and registry studies on noncemented TKA.
• Analysis of implant designs focusing on porous coatings and fixation mechanisms.
• Evaluation of survivorship data and clinical outcomes for uncemented implants.

Main Results:

• Early noncemented TKA designs had high failure rates.
• Recent screwless designs with enhanced porous coatings show improved survivorship in smaller series.
• Larger registry studies are needed to fully confirm the long-term success of modern noncemented TKA.

Conclusions:

• Noncemented TKA presents an alternative fixation method with potential benefits for specific patient populations.
• Advances in implant design, such as improved porous surfaces, aim to enhance bony ingrowth and implant stability.
• Surgeons require comprehensive awareness of the advantages and limitations of noncemented TKA to optimize patient outcomes.