Cementless tibial components have excellent implant survivorship with no cases of aseptic tibial loosening at 10 years follow up

The popularity of cementless total knee arthroplasty (TKA) is on the rise because of innovations in implant designs and surgical technique as well as the fact that greater than 50% of TKAs are performed in patients less than age 65 years. The 2021 American Joint Replacement Registry report indicates that 14% of all primary TKAs are cementless.

E. Gibon et al. conducted Randimized Control Trial with three arms at ‘Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota’ after approval from institutional review board and with specific written informed consent. This study has been awarded ‘John N. Insall Award’ at the 2023 Knee Society Awards.

389 primary TKAs were randomized: traditional modular cemented tibia (135); hybrid (cemented baseplate with uncemented pegs) monoblock tibia (128); and cementless monoblock tibia (126).

The inclusion criteria included patients aged 20 to 85 years, who underwent unilateral TKA for end-stage knee disease secondary to degenerative or post-traumatic arthritis. The exclusion criteria included patients younger than 20 years or older than 85 years, severe deformity with greater than 20º of varus, valgus, or fixed flexion deformity, history of infection, major musculoskeletal or neurological disorders, or disease that may adversely affect normal gait or weight-bearing, metastatic disease, any congenital, developmental, or other bone disease or previous knee surgery that may interfere with total knee success (eg, Paget’s disease, Charcot’s disease), severe osteoporosis or previous high tibial osteotomy, presence of previous prosthetic knee arthroplasty device, arthrodesis of the affected knee, and/or patients not undergoing patella resurfacing.