“…In a randomized controlled study, Gao et al (14), using RSA, found similar results in terms of migration, clinical outcomes, and survival rates of 41 TKAs in young patients (<60 years) undergoing knee replacement (NexGen, Zimmer, Warsaw, USA): 22 with fully cemented implants and 19 with hybrid fixated implants. Yang et al (18), following up 235 TKAs, performed with a hybrid fixation technique and using five different knee systems, reported a survival rate of 95% at ten years, and then of 92% at fifteen years. Cementation of the patellar component is crucial: it is now clear that cementless patellas are associated with a high risk of failure due to early loosening of the component.…”