Cementless Fixation in Total Knee Arthroplasty – Current Evidence and Future Perspective

Introduction: Cementless fixation plays an increasing role in total knee arthroplasty (TKA). The objective of this review article is to analyze functional outcomes and survivorship of cementless TKA. Materials and methods: A comprehensive literature search for studies reviewing the outcome and survivorship of cementless TKA was conducted. This search was based on the PRISMA 2020 guidelines using PubMed, Medline, and Embase. The included studies were screened by two independent observers. Results: From 2010 to 2022, fifteen studies were included. Eleven studies compared cementless and cemented TKA. Four studies only covered cementless implants. Survivorship and functional outcomes of cementless TKA are at least comparable to those of cemented implants. Conclusion: With improvement in manufacturing, and surgical tools for more precise delivery, such as robotic assisted TKA and 3D-printed implants, one can expect increase in usage of cementless TKA, due to a more biological fixation, better survivorship, and outcomes.