Cementless total knee arthroplasty in post-traumatic or Post-ACL knees: A case series

Advancements in prosthetic technology have allowed for the reemergence of cementless fixation particularly in younger or obese patients [1-4]. While previous research on cementless fixation in varied populations is promising, there are few studies, to our knowledge, investigating outcomes in patients with post-traumatic osteoarthritis. The objective of this case series was to analyze the clinical outcomes and reoperation rates of cementless total knee arthroplasty (TKA) for post-traumatic arthritis.

This study was an institutional review board (IRB) exempt retrospective review of cementless TKAs at an academic, tertiary referral center. Patients with a history of anterior cruciate ligament (ACL) reconstruction and/or knee trauma were included. Basic univariate statistics were used to analyze the data.

Eight patients were included: three patients with a history of ACL reconstruction, two with a prior femoral fracture, one with a history of patellar fracture and open reduction and internal fixation of the tibial plateau, one with a tibial fracture, and one patient with a previous fracture of the tibia and femur. The mean age at surgery was 57.5 years. One patient was lost to follow-up. There were no acute complications, and mean follow-up time was 10.1 months in the remaining seven patients. At four months post-operative, one patient had an acute prosthetic infection after a spine infection that was effectively treated with irrigation & debridement (I&D) polyethylene exchange.

While the sample size and follow-up time is limited, use of cementless implants in TKA is safe in post-ACL or post-traumatic knees in the short-term and indicates the need for more research in this patient population.