Short-term results of triathlon cementless versus cemented primary total knee arthroplasty

Recent studies have demonstrated that aseptic loosening remains a leading cause of failure after total knee arthroplasty (TKA). Cementless fixation is a possible strategy for countering this problem. This study compared short-term survivorship and functional results of patients undergoing primary TKA with cementless versus cemented implants.

A multi-center database was utilized to identify 3849 patients undergoing primary TKA between 2012 and 2017 with a minimum two-year follow-up. Patients were divided into cementless (699), and cemented TKA (3150). The outcome of TKA including revision for aseptic or septic reasons, and other outcome variables were compared. Six hundred five patients from the cementless group (case) were matched with 605 patients from the cemented group (controls). Both groups were compared for outcomes and related variables.

Both matched groups were similar in age, race, gender, height, weight, BMI, laterality, femoral component type, follow-up duration, preoperative and postoperative physical and mental health, and functional activities (all p-values>0.05). Although the cementless TKA group had more components in varus alignment (p = 0.015) and were taller (p < 0.001), the aseptic revision rate and time to failure were similar in both groups (p-values = 0.256 and 0.0890 respectively). The rate of revision for infection was also the same in both groups (p = 0.452).

Cementless TKA demonstrated an equivalent rate of aseptic and septic failure when compared to cemented TKA in the short-term. Time to aseptic failure was also similar in both groups.