Knee implant kinematics are task-dependent.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: R.L. has received speaker's fees from Medacta and DePuy Synthes. R.L. has received research funding from DePuy Synthes and Medacta International. 8. J Arthroplasty. 2024 Sep;39(9 Suppl 2):S45-S53. doi: 10.1016/j.arth.2024.02.078. Epub 2024 Mar 7. Cementless Total Knee Arthroplasty: A Resurgence-Who, When, Where, and How? Mosher ZA(1), Bolognesi MP(2), Malkani AL(3), Meneghini RM(4), Oni JK(5), Fricka KB(1). Author information: (1)Anderson Orthopaedic Research Institute (AORI), Alexandria, Virginia; Inova Mount Vernon Hospital Joint Replacement Center, Alexandria, Virginia. (2)Department of Orthopaedic Surgery, Duke University, Durham, North Carolina. (3)Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky. (4)Indiana Joint Replacement Institute, Indianapolis, Indiana; Department of Orthopaedic Surgery, Indiana University, Indianapolis, Indiana. (5)Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland. BACKGROUND: Total knee arthroplasty (TKA) is one of the most common procedures in orthopaedics, but there is still debate over the optimal fixation method for long-term durability: cement versus cementless bone ingrowth. Recent improvements in implant materials and technology have offered the possibility of cementless TKA to change clinical practice with durable, stable biological fixation of the implants, improved operative efficiency, and optimal long-term results, particularly in younger and more active patients. METHODS: This symposium evaluated the history of cementless TKA, the recent resurgence, and appropriate patient selection, as well as the historical and modern-generation outcomes of each implant (tibia, femur, and patella). Additionally, surgical technique pearls to assist in reliable, reproducible outcomes were detailed. RESULTS: Historically, cemented fixation has been the gold standard for TKA. However, cementless fixation is increasing in prevalence in the United States and globally, with equivalent or improved results demonstrated in appropriately selected patients. CONCLUSIONS: Cementless TKA provides durable biologic fixation and successful long-term results with improved operating room efficiency. Cementless TKA may be broadly utilized in appropriately selected patients, with intraoperative care taken to perform meticulous bone cuts to promote appropriate bony contact and biologic fixation. Copyright © 2024 Elsevier Inc. All rights reserved. DOI: 10.1016/j.arth.2024.02.078