Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Feb 29;17(5):1136.
doi: 10.3390/ma17051136.

Cemented vs. Cementless Fixation in Primary Knee Replacement: A Narrative Review

Mikołaj Wilczyński  1 , Michał Bieniek  1 , Przemysław Krakowski  1   2 , Robert Karpiński  3
Affiliations
Review

Cemented vs. Cementless Fixation in Primary Knee Replacement: A Narrative Review

Mikołaj Wilczyński et al. Materials (Basel). .

Abstract

Knee osteoarthritis (OA) is one of the leading causes of disability around the globe. Osteoarthritis is mainly considered a disease affecting the elderly. However, more and more studies show that sports overuse, obesity, or congenital disorders can initiate a pathologic cascade that leads to OA changes in the younger population. Nevertheless, OA mostly affects the elderly, and with increasing life expectancy, the disease will develop in more and more individuals. To date, the golden standard in the treatment of the end-stage of the disease is total joint replacement (TJR), which restores painless knee motion and function. One of the weakest elements in TJR is its bonding with the bone, which can be achieved by bonding material, such as poly methyl-methacrylate (PMMA), or by cementless fixation supported by bone ingrowth onto the endoprosthesis surface. Each technique has its advantages; however, the most important factor is the revision rate and survivor time. In the past, numerous articles were published regarding TJR revision rate, but no consensus has been established yet. In this review, we focused on a comparison of cemented and cementless total knee replacement surgeries. We introduced PICO rules, including population, intervention, comparison and outcomes of TJR in a PubMed search. We identified 783 articles published between 2010 and 2023, out of which we included 14 in our review. Our review reveals that there is no universally prescribed approach to fixate knee prostheses. The determination of the most suitable method necessitates an individualized decision-making process involving the active participation and informed consent of each patient.

Keywords: bone cements; knee; osteoarthritis; total knee arthroplasty (TKA); total knee replacement (TKR).

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of included studies—PRISMA 2020.
Figure 2
Figure 2
Conventional radiograph presenting cemented total knee replacement.
Figure 3
Figure 3
Presentation of different types of fixation used in primary TKR based on national registries.
Figure 4
Figure 4
Conventional X-ray showing septic loosening of the TKR with bone destruction (asterisk) and loosening of the implants (arrows).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Cameron K., Hsiao M., Owens B., Burks R., Svoboda S.J. Incidence of Physician-Diagnosed Osteoarthritis AmongActive Duty United States Military Service Members. Arthritis Rheumatol. 2011;63:2974–2982. doi: 10.1002/art.30498. - DOI - PubMed
    1. Martin-Rodriguez E., Guillen-Grima F., Martí A., Brugos-Larumbe A. Comorbidity Associated with Obesity in a Large Population: The APNA Study. Obes. Res. Clin. Pract. 2015;9:435–447. doi: 10.1016/j.orcp.2015.04.003. - DOI - PubMed
    1. Flegal K.M., Panagiotou O.A., Graubard B.I. Estimating Population Attributable Fractions to Quantify the Health Burden of Obesity. Ann. Epidemiol. 2015;25:201–207. doi: 10.1016/j.annepidem.2014.11.010. - DOI - PMC - PubMed
    1. Dulay G.S., Cooper C., Dennison E.M. Knee Pain, Knee Injury, Knee Osteoarthritis & Work. Best. Pract. Res. Clin. Rheumatol. 2015;29:454–461. doi: 10.1016/j.berh.2015.05.005. - DOI - PubMed
    1. Papadopoulos E.C., Parvizi J., Lai C.H., Lewallen D.G. Total Knee Arthroplasty Following Prior Distal Femoral Fracture. Knee. 2002;9:267–274. doi: 10.1016/S0968-0160(02)00046-7. - DOI - PubMed

LinkOut - more resources