Cementless Total Knee Arthroplasty: A State-of-the-Art Review

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Medical device engineering

Background:

• The demographic profile of total knee arthroplasty (TKA) candidates is shifting towards younger, more active individuals.
• While cemented fixation is the standard, cementless fixation is gaining interest as a potentially more durable alternative.
• Advances in manufacturing enhance the prospects for long-term biological fixation in cementless implants.

Purpose of the Study:

• To evaluate the current status and future prospects of cementless fixation in TKA.
• To compare the outcomes of modern cementless TKA designs with traditional cemented designs.
• To highlight the importance of patient selection for cementless TKA success.

Main Methods:

• Review of current research and clinical data on cemented versus cementless TKA.
• Analysis of outcomes based on patient demographics and fixation methods.
• Consideration of technological advancements in implant design and manufacturing.

Main Results:

• Intermediate to long-term outcomes of modern cementless TKA designs are comparable to cemented designs.
• Patient selection is a critical factor for successful cementless fixation.
• Growing interest in cementless fixation due to potential for enhanced durability.

Conclusions:

• Modern cementless TKA demonstrates comparable efficacy to cemented TKA, particularly with appropriate patient selection.
• Further high-quality research is needed to fully elucidate the relative benefits of cemented versus cementless TKA systems.
• Technological advancements are improving the viability of cementless fixation for TKA.