Cemented Versus Cementless Total Knee Arthroplasty: Analysis of the Latest Literature Data

Abstract

The use of cementless total knee arthorplasty (TKA) has increased in recent years to the detriment of the use of cemented TKA. However, there is still no agreement on when to cement and in whom. A recent meta-analysis has shown that the cumulative survival at 12 years was 97% for the cementless implants and 89% for the cemented implants. Besides, no differences between the cemented and cementless TKAs were found in patient-reported results and revision rates. Another study showed noninferiority to cemented TKA. Its authors stated that cementles TKA can be utilized as an alternative mode of fixation in individuals opting for primary TKA. However, it was mentioned that additional long-run follow-up was required to confirm if cementless TKA can exhibit improved survivorship over cemented TKA. In individuals > 70 years of age, cementless TKA accomplished clinical scores equivalent to those of younger individuals at 2-year follow-up. Cementless TKA seemed to be a safe alternative for older individuals. Another meta-analysis has shown a substantial reduction in all-cause revisions and revisions for aseptic loosening when utilizing cementless fixation in high body mass index individuals when compared to the usage of cemented implants. In conclusion, clinical practice guidelines are required to ensure safe and efficacious usage of cementless fixation. Level of evidence: III