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Cementless fixation in total knee arthroplasty: current evidence and future perspective
David J Haslhofer1, Nikolaus Kraml2, Christian Stadler2
1Department for Orthopedics and Traumatology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstrasse 9, 4020 Linz and Altenberger Strasse 69, 4040, Linz, Austria. david.haslhofer@gmx.at.
Cementless total knee arthroplasty (TKA) shows functional outcomes and survivorship comparable to cemented TKA. Advancements in manufacturing and surgical techniques suggest increased future use of cementless TKA for better biological fixation.
Area of Science:
- Orthopedic surgery
- Biomaterials science
Background:
- Cementless fixation is increasingly utilized in total knee arthroplasty (TKA).
- This review analyzes the functional outcomes and survivorship of cementless TKA.
Purpose of the Study:
- To review and analyze functional outcomes.
- To assess the survivorship of cementless TKA.
Main Methods:
- Comprehensive literature search adhering to PRISMA 2020 guidelines.
- Databases searched include PubMed, Medline, and Embase.
- Study screening conducted by two independent observers.
Main Results:
- Fifteen studies published between 2010 and 2022 were included.
- Eleven studies compared cementless and cemented TKA; four focused solely on cementless implants.
- Cementless TKA demonstrates functional outcomes and survivorship at least comparable to cemented TKA.
Conclusions:
- Improvements in manufacturing and surgical tools (robotic-assisted TKA, 3D-printed implants) are enhancing cementless TKA.
- Expected increase in cementless TKA usage due to superior biological fixation, survivorship, and outcomes.
