Cementless versus cemented fixation in image-based robotic total knee arthroplasty guided by functional knee positioning principles.

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Abstract

Conflict of interest statement: Authors 1, 2, 3, and 4 have nothing to declare. Author 5: Consultant for Smith and Nephew. Author 6: Consultant for Smith and Nephew and Stryker. Author 7: Royalties from Smith Nephew, Stryker, and Serf. Consultant for Stryker, Heraeus; Institutional research support from Amplitude and Groupe Lepine; Editorial Board for Journal of Bone and Joint Surgery (Am). 4. Orthopedics. 2013 May;36(5):380-7. doi: 10.3928/01477447-20130426-10. Comparison of cemented and uncemented fixation in total knee arthroplasty. Brown TE(1), Harper BL, Bjorgul K. Author information: (1)Division of Adult Reconstruction, Department of Orthopaedics, University of Virginia, Charlottesville, Virginia 22903, USA. tb4g@hscmail.mcc.virginia.edu As a result of reading this article, physicians should be able to :1. Understand the rationale behind using uncemented fixation in total knee arthroplasty.2.Discuss the current literature comparing cemented and uncemented total knee arthroplasty3. Describe the value of radiostereographic analysis in assessing implant stability.4. Appreciate the limitations in the available literature advocating 1 mode of fixation in total knee arthroplasty. Total knee arthroplasty performed worldwide uses either cemented, cementless, or hybrid (cementless femur with a cemented tibia) fixation of the components. No recent literature review concerning the outcomes of cemented vs noncemented components has been performed. Noncemented components offer the potential advantage of a biologic interface between the bone and implants, which could demonstrate the greatest advantage in long-term durable fixation in the follow-up of young patients undergoing arthroplasty. Several advances have been made in the backing of the tibial components that have not been available long enough to yield long-term comparative follow-up studies. Short-term radiostereographic analysis studies have yielded differing results. Although long-term, high-quality studies are still needed, material advances in biologic fixation surfaces, such as trabecular metal and hydroxyapatite, may offer promising results for young and active patients undergoing total knee arthroplasty when compared with traditional cemented options. Copyright 2013, SLACK Incorporated. DOI: 10.3928/01477447-20130426-10