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Cementless Primary Total Knee Arthroplasty Will this be the Future?

Omar A Behery, Andrew J Clair, William J Long

    Bulletin of the Hospital for Joint Disease (2013)
    |March 11, 2021
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    Summary

    Cementless total knee arthroplasty (TKA) shows promising results due to improved designs and porous metal technology. Modern cementless TKAs offer survivorship comparable to cemented options, with potential long-term cost savings.

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    Area of Science:

    • Orthopedic surgery
    • Biomaterials science
    • Implant technology

    Background:

    • Cementless fixation in total knee arthroplasty (TKA) aims for biological osseointegration and long-term implant stability.
    • Early cementless TKA designs faced challenges with tibial and patellar component failures.
    • Recent advancements in porous metal technology and biomechanical stability have revived interest in cementless TKA.

    Purpose of the Study:

    • To evaluate the efficacy and outcomes of modern cementless total knee arthroplasty (TKA).
    • To compare the performance of cementless TKA with traditional cemented TKA.
    • To explore the potential cost-effectiveness and future trends of cementless TKA.

    Main Methods:

    • Review of modern cementless TKA designs and surgical techniques.
    • Analysis of early- and mid-term survivorship data for cementless TKA.
    • Comparison of outcomes with historical cemented TKA data.

    Main Results:

    • Modern cementless TKA designs demonstrate excellent early- and mid-term survivorship, comparable to cemented TKA.
    • Surgical technique for cementless TKA requires precision in indications, resections, and alignment.
    • Emerging evidence suggests potential overall cost savings for cementless TKA due to reduced operative time and supply costs.

    Conclusions:

    • Modern cementless TKA implants achieve outcomes equivalent to cemented implants in early to mid-term follow-up.
    • Long-term comparative studies are necessary to fully assess cementless TKA longevity.
    • Increasingly younger and active patient populations undergoing TKA are likely to drive greater adoption of cementless implants.