Redefining Indications for Modern Cementless Total Knee Arthroplasty: Clinical Outcomes and Survivorship in Patients >75 Years Old

Effect of Tobacco Use on Radiolucent Lines in Modern Cementless Total Knee Arthroplasty Tibial Components

“…Furthermore, contemporary implant designs with highly porous biomaterials have led to excellent survivorship of a select few historical designs and modern cementless TKA designs [ 20 , 25 , 29 ]. After removing failures due to metal-backed patellae, Ritter and Meneghini [ 20 ] demonstrated 97% survivorship of anatomic graduated cementless TKAs out to 20 years.…”

“…Recently, there have been investigations into the role of biologic fixation of cementless TKA in patients over 75 years of age. In a propensity-matched cohort study comparing cemented to cementless TKA patients over 75 years of age, there was no difference in Knee Injury and Osteoarthritis Outcome Score for Joint Replacement or Short Form-12 final postoperative scores or improvement scores at 2 years [ 25 ]. Furthermore, survivorship free from aseptic revision was not different between cemented and cementless cohorts (99% vs 100%) at mean follow-up of 4.2 years (range 2.0-7.9) [ 25 ].…”

“…In a propensity-matched cohort study comparing cemented to cementless TKA patients over 75 years of age, there was no difference in Knee Injury and Osteoarthritis Outcome Score for Joint Replacement or Short Form-12 final postoperative scores or improvement scores at 2 years [ 25 ]. Furthermore, survivorship free from aseptic revision was not different between cemented and cementless cohorts (99% vs 100%) at mean follow-up of 4.2 years (range 2.0-7.9) [ 25 ]. Despite the expanding interest for indications of cementless TKA, there remains a paucity of data on the effect of tobacco usage on biologic fixation in cementless TKA.…”

“…Historically, previous cementless TKA designs resulted in early failure though some designs have demonstrated excellent revision free survivorship at 20 years when excluding failures of metal-backed patellae [ 3 , 20 ]. With advances in prosthetic design, instrumentation, operative technique, and the emergence of highly porous metals for fixation, recent studies report encouraging results with modern cementless TKA designs [ 7 , [21] , [22] , [23] , [24] , [25] , [26] , [27] ]. Furthermore, recent data support lower early rates of aseptic loosening in patients who undergo cementless TKA compared to cemented TKA [ 21 , 25 , 26 , 28 , 29 ].…”

“…With advances in prosthetic design, instrumentation, operative technique, and the emergence of highly porous metals for fixation, recent studies report encouraging results with modern cementless TKA designs [ 7 , [21] , [22] , [23] , [24] , [25] , [26] , [27] ]. Furthermore, recent data support lower early rates of aseptic loosening in patients who undergo cementless TKA compared to cemented TKA [ 21 , 25 , 26 , 28 , 29 ].…”