Abstract:

There are three broad strategies for component fixation in total knee arthroplasty (TKA): cemented, cementless, and hybrid (cemented tibia, uncemented femur). Cemented TKA remains the current gold standard, with reliable long-term results. National joint registry data indicates that uncemented tibial components have the highest revision rates, and clinical and RSA studies suggest this is the result of lower initial stability when compared with cemented tibial components. However, young, active, high-demand patients may warrant a consideration of accepting the slightly increased risk of early failure for the potential benefit of long-term osseointegration, which may result in the, as yet elusive, "knee replacement for a lifetime."

Authors:

Shane Guerin, MCh, MEng, FRCSI (Tr & Orth), Arthroplasty Fellow, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada, Chris Jones, MB, BS, FRACS (Orth), Arthroplasty Fellow, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada, R. Michael Meneghini, MD, Director of Joint Replacement, Indiana University Health Saxony Hospital, Assistant Professor of Clinical Orthopedic Surgery, Indiana University School of, Medicine, Indianapolis, Indiana, Michael J. Dunbar, MD, FRCSC, PhD, Professor of Surgery, Professor of Biomedical Engineering, Professor of Community Health and Epidemiology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada

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