Early Outcomes of Cemented versus Cementless Total Knee Arthroplasty

Abstract

Introduction. Total knee arthroplasty (TKA) has been provento be very effective for long-term pain relief in the degenerativeknee. Few studies have investigated short-term clinicaland functional outcomes between the cemented and cementlessTKA. The specific aim of this study was to assess the potentialdifference of functional outcomes in the early postoperativeperiod between these two surgical options usingthe Knee Society Score (KSS) and range of motion (ROM).
 Methods. A total of 164 knees that had undergone TKA by a singlesurgeon at a single institution between 2007 and 2010 were reviewed.Three different TKA prosthetic designs (cruciate retaining(CR), posterior stabilized (PS) and cruciate substituting (CS))were included. Data collection included patient demographics,pre- and post-operative ROM, and pre- and post-operative KSSat each visit (1.5 months, 3 months, and 12 months). Two separateKSS scores were assigned: functional score and clinical score.
 Results. Sixty-seven knees underwent cemented TKA and 97knees underwent cementless TKA. No significant differencewas recognized in either age or body mass index for thesetwo TKA groups. The cementless group showed a significantearly ROM improvement after 1.5 months post-operative (p <0.05), while the cemented group showed ROM improvementonly after three months post-operative. No significant differencewas detected in terms of KSS between the cemented andcementless TKA groups at each measured time period. Bothgroups showed marked KSS improvement (cemented: 135%,cementless: 125%) after 1.5 months post-operative and theKSS seemed to be stabilized after three months post-operativefor both groups (cemented: p = 0.36; cementless: p = 0.07).
 Conclusions. There was a significant early ROM improvementfor the cementless TKA group compared to the cementedTKA group, but no statistical significant difference was notedin KSS in the early post-operative period when comparing cementedand cementless TKA groups. The findings provide evidencethat cementless TKA patients can undergo an identicalpost-operative protocol to cemented TKA, without concernsabout implant stability or function. KS J Med 2016;9(4):93-98.