Clinical Scorecard: Cementless and Cemented Total Knee Arthroplasty: A Non-randomised Comparison of Joint-Awareness Outcomes
At a Glance
Category
Detail
Condition
Clinical topic addressed by the source article: Cementless TKA Is Associated With Fewer Poor Joint-Awareness Outcomes Than a Cemented Implant of the Same Design
Key Mechanisms
Mechanisms or clinical associations described in the source article.
Target Population
Population described in the source article.
Care Setting
Single-institution, non-randomised, two-cohort study of 109 consecutive primary TKAs performed from January 2021 through July 2022.
Key Highlights
The study compared 55 cemented and 54 cementless TKAs using the same implant design.
Cohort allocation was non-random and based on surgeon preference; younger patients were more often assigned cementless fixation.
The groups differed significantly in age, sex distribution, and BMI, while preoperative Oxford Knee Score and ASA classification did not differ significantly.
Outcomes assessed included the 24-month Forgotten Joint Score-12 and Oxford Knee Score, patient acceptable symptom state, and time to functional satisfaction.
The supplied article excerpt does not include study results, so comparative outcome findings cannot be reported.
Guideline-Based Recommendations
Diagnosis
Eligibility was assessed in patients undergoing primary TKA for end-stage bone-on-bone knee osteoarthritis.
Management
The study used either cemented or cementless fixation with the same implant design; fixation assignment was non-random and based on surgeon preference.
A fast-track rehabilitation protocol began a few hours after surgery and included full weight-bearing, walking, training, and isometric exercises.
Monitoring & Follow-up
Follow-up assessments were scheduled at 3 weeks, 6 weeks, 6 months, 12 months, and 24 months.
Radiographic follow-up used anteroposterior and lateral weight-bearing views to assess implant positioning, radiolucent lines, and evidence of loosening.
Oxford Knee Score was collected preoperatively and at 24 months; Forgotten Joint Score-12 was collected at 24 months.
Risks
Non-random cohort allocation produced significant baseline differences in age, sex distribution, and BMI.
Valgus deformity and bilateral surgery were exclusion criteria.
Patient & Prescribing Data
109 consecutive patients undergoing primary unilateral TKA for end-stage bone-on-bone knee osteoarthritis: 55 cemented and 54 cementless procedures.
The cementless femoral component was 3D-printed Ti6Al4V with a 70% porous bone-facing surface and 520-µm pores; the cemented femoral component was cobalt-chromium alloy. Both versions had the same articular geometry and titanium-niobium nitride coating on the articulating surface; both tibial components were titanium.
Clinical Best Practices
The study used one high-volume, fellowship-trained adult knee reconstruction surgeon for all procedures.
The surgical protocol included mechanical alignment and measured resection; patellar resurfacing was not performed.
The cementless group’s bone cuts were made with a 1.27-mm saw blade under saline irrigation to prevent thermal necrosis.
The reported perioperative protocol included intravenous tranexamic acid, cefazolin, and postoperative enoxaparin prophylaxis.
