Cementless Total Knee Arthroplasty: A Resurgence—Who, When, Where, and How?

• Published in: The Journal of arthroplasty Vol. 39; no. 9; pp. S45 - S53
• Main Authors: Mosher, Zachary A., Bolognesi, Michael P., Malkani, Arthur L., Meneghini, R. Michael, Oni, Julius K., Fricka, Kevin B.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2024
• Subjects: cementless; cementless total knee arthroplasty; fixation; patient selection; surgical technique; total knee arthroplasty; fixation; total knee arthroplasty; surgical technique; patient selection; cementless total knee arthroplasty; cementless
• ISSN: 0883-5403; 1532-8406; 1532-8406
• DOI: 10.1016/j.arth.2024.02.078

Total knee arthroplasty (TKA) is one of the most common procedures in orthopaedics, but there is still debate over the optimal fixation method for long-term durability: cement versus cementless bone ingrowth. Recent improvements in implant materials and technology have offered the possibility of cementless TKA to change clinical practice with durable, stable biological fixation of the implants, improved operative efficiency, and optimal long-term results, particularly in younger and more active patients. This symposium evaluated the history of cementless TKA, the recent resurgence, and appropriate patient selection, as well as the historical and modern-generation outcomes of each implant (tibia, femur, and patella). Additionally, surgical technique pearls to assist in reliable, reproducible outcomes were detailed. Historically, cemented fixation has been the gold standard for TKA. However, cementless fixation is increasing in prevalence in the United States and globally, with equivalent or improved results demonstrated in appropriately selected patients. Cementless TKA provides durable biologic fixation and successful long-term results with improved operating room efficiency. Cementless TKA may be broadly utilized in appropriately selected patients, with intraoperative care taken to perform meticulous bone cuts to promote appropriate bony contact and biologic fixation.