Cementless Total Knee Arthroplasty Outcomes Are Comparable Across Age Groups: A National Database Study

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Geriatric Medicine

Background:

• Cementless total knee arthroplasty (TKA) is increasingly used.
• Advanced age is often considered a relative contraindication for TKA.
• Limited data exists on age-specific outcomes for cementless TKA.

Purpose of the Study:

• To assess the impact of advanced age on complication rates after cementless TKA.
• To stratify patients into age groups: < 60, 60-70, 70-80, and > 80 years.
• To evaluate rates of periprosthetic fracture (PPFx), infection, aseptic loosening, and revision.

Main Methods:

• Utilized a national all-payer database (2010-2023) for cementless TKA patients.
• Excluded patients with traumatic etiology or malignancy.
• 1:1 matched cohorts (n=1,134 each) based on comorbidities, sex, and lifestyle factors.

Main Results:

• No significant differences in PPFx, infection, aseptic loosening, or aseptic revision were found across age groups at 90 days, 1 year, or 2 years.
• The > 80-year cohort showed no increased risk of aseptic loosening or PPFx compared to the < 60-year cohort at 2 years.

Conclusions:

• Complication rates for cementless TKA are comparable across all age groups.
• Cementless fixation is a viable option for TKA patients, irrespective of age.
• Age should not be a contraindication for considering cementless TKA.