Cementless Total Knee Arthroplasty: A Resurgence-Who, When, Where, and How?

Autor: Mosher ZA; Anderson Orthopaedic Research Institute (AORI), Alexandria, Virginia; Inova Mount Vernon Hospital Joint Replacement Center, Alexandria, Virginia., Bolognesi MP; Department of Orthopaedic Surgery, Duke University, Durham, North Carolina., Malkani AL; Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky., Meneghini RM; Indiana Joint Replacement Institute, Indianapolis, Indiana; Department of Orthopaedic Surgery, Indiana University, Indianapolis, Indiana., Oni JK; Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland., Fricka KB; Anderson Orthopaedic Research Institute (AORI), Alexandria, Virginia; Inova Mount Vernon Hospital Joint Replacement Center, Alexandria, Virginia.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2024 Sep; Vol. 39 (9S2), pp. S45-S53. Date of Electronic Publication: 2024 Mar 07.
DOI: 10.1016/j.arth.2024.02.078
Abstrakt: 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.)
Databáze: MEDLINE
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