Cemented Versus Noncemented Total Knee Arthroplasty Outcomes

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Medical device engineering

Background:

• Aseptic loosening is a primary cause for revision total knee arthroplasty (TKA).
• Younger, active patient demographics prompt reevaluation of noncemented fixation for TKA.
• Noncemented fixation may offer lower long-term aseptic loosening rates.

Purpose of the Study:

• To compare demographics and complication rates between cemented and noncemented TKA.
• To evaluate the risk-adjusted complication profiles of cemented versus noncemented TKA.
• To analyze outcomes at 90 days, 1 year, and 2 years post-surgery.

Main Methods:

• Utilized the MKnee database subset for patient identification.
• Included patients undergoing TKA for osteoarthritis with a minimum 2-year follow-up.
• Employed propensity score matching for risk-adjusted complication analysis.

Main Results:

• Noncemented TKA was linked to increased periprosthetic joint infection risk (ORs 1.34-1.27).
• Noncemented TKA demonstrated higher periprosthetic fracture risk at 1 and 2 years (ORs 2.19, 1.89).
• No significant difference in aseptic loosening rates was observed between cemented and noncemented TKA.

Conclusions:

• Noncemented TKA is associated with elevated rates of periprosthetic joint infection and fracture.
• Long-term aseptic loosening rates require further investigation for both fixation methods.
• Current evidence does not support noncemented TKA over cemented TKA for reducing aseptic loosening.