Orthopedics Today reports on the case for and against the use of cementless total knee arthroplasty (TKA) according to experts including Geoffrey H. Westrich, MD, hip and knee surgeon at HSS.

Although total knee arthroplasty has been commonly performed with cemented fixation, research has shown an increase in cementless fixation during the years.

The American Joint Replacement Registry showed cementless fixation was used in more than 14% of primary TKAs in 2020, while the Swedish Knee Arthroplasty Registry and National Joint Registry reported an increase in the use of cementless fixation of 8% and 4.2%, respectively.

Primarily performed in relatively sedentary older patients, the indications for TKA have expanded to include patients aged 65 years and younger. While cemented TKA may provide long-term survivorship in older patients, Dr. Westrich said younger patients had higher revision rates with cemented TKA possibly due to increased activity levels. Previously published research using radiostereometric analysis also has shown that patients who underwent TKA with cemented fixation had stability at 1-year follow-up but implant migration at 10-year follow-up, which is an indication of potential loosening, according to Westrich. He said this differed from patients who underwent TKA with cementless fixation.

“At 1 year, there may be a bit of settling in [with cementless fixation], but [the implants] are rock solid at year 10,” Dr. Westrich said.

Read the full article at healio.com.