Clinical Report: Cementless TKA and Poor Joint-Awareness Outcomes

Overview

This prospective, non-randomised, single-institution study compared 55 cemented and 54 cementless TKAs using the same implant design. The supplied article text describes the study rationale and methods but does not provide postoperative outcome results, so it does not establish whether either fixation method produced fewer poor joint-awareness outcomes.

Background

Cemented fixation has been the established standard for TKA for more than 40 years, while cementless designs have evolved with porous, additively manufactured surfaces intended to support osseointegration. Prior comparative studies cited in the article have generally reported equivalent mean clinical outcomes, but the authors note limitations in registry data and a focus on average outcomes in much of the comparative evidence. This study was designed to assess patient-reported outcomes across their distribution, including joint awareness measured with the Forgotten Joint Score-12. The AAOS guideline context supplied here reports comparable functional outcomes and complication or reoperation rates for all-cemented and hybrid fixation, without recommending one strategy as superior.

Data Highlights

Key Findings

• The study included 109 consecutive primary unilateral TKAs performed from January 2021 through July 2022 at one institution; valgus deformity and bilateral surgery were exclusion criteria.
• Allocation was non-random and based on surgeon preference; younger patients were more often assigned cementless fixation and older patients cemented fixation.
• The groups differed significantly in age, sex distribution, and BMI, while preoperative Oxford Knee Score and ASA classification did not differ significantly.
• Both groups received the same GKS Prime Flex CR implant design with anterior-stabilized polyethylene; the cementless femoral component was 3D-printed Ti6Al4V with a highly porous bone-facing surface.
• The stated outcomes included the Forgotten Joint Score-12, Oxford Knee Score, and Patient Acceptable Symptom State, with comparisons planned at the mean and across the outcome distribution; postoperative results are not included in the supplied text.
• The supplied AAOS guideline context describes comparable functional outcomes and complication or reoperation rates for all-cemented versus hybrid fixation and does not identify a superior strategy.

Clinical Implications

The supplied material does not include the study's postoperative results, so it cannot support a conclusion about comparative joint awareness or a fixation preference. Interpretation of any reported group differences would also need to account for non-random allocation and baseline differences in age, sex, and BMI.

Conclusion

The article describes a comparison of cemented and cementless versions of the same TKA design, with attention to the full distribution of patient-reported outcomes. Because outcome results are absent from the provided text, the title's comparative claim cannot be verified from this material.

Related Resources & Content

1. American Academy of Orthopaedic Surgeons, Clinical Practice Guideline, 2023 -- Surgical Management of Osteoarthritis of the Knee
2. Archives of Orthopaedic and Trauma Surgery, 2025 -- Uncemented total knee arthroplasty is associated with higher complication rates: a propensity-matched retrospective study
3. Uncemented Fixation Techniques in Total Knee Arthroplasty: Current Research and Future Directions, 2024
4. MDSpire News -- Cementless Knee Implants Show Superior Outcomes in Patients With Obesity
5. Elevated Incidence of Deep Vein Thrombosis and Surgical Site Infections Following Cemented Total Knee Arthroplasty: A Nationwide Propensity Score-Matched Analysis in Japan
6. AAOS Clinical Practice Guideline: Surgical Management of Osteoarthritis of the Knee
7. A Systematic Review of Randomized Controlled Trials on Contemporary Cementless Total Knee Arthroplasty
8. Superior Sensitivity of the Forgotten Joint Score in Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials
9. CEMENTLESS FIXATION: ALL CEMENTED COMPONENTS VS. HYBRID FIXATION (CEMENTLESS FEMORAL COMPONENT)
10. A Systematic Review of Randomized Controlled Trials on Contemporary Cementless Total Knee Arthroplasty - ScienceDirect
11. Superior Sensitivity of the Forgotten Joint Score in Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials - PMC