Abstract
Background Newer generation cementless total knee arthroplasty (TKA) designs have provided stronger
osteointegration between the implant and bone. Despite excellent survivorship and
outcomes with cemented TKAs, areas of concern within the bone–cement interface remain
a concern and necessitate studies on alternative constructs. This study assesses:
(1) implant survivorship; (2) clinical outcomes; and (3) complications with radiographic
outcomes at a 5-year minimum follow-up of cementless highly porous titanium-coated
baseplates in TKAs.
Methods Part of this study has been reported. We retrospectively reviewed a prospectively
collected database at a single high-volume institution between July 1, 2013 and June
30, 2014 for patients who underwent a primary TKA using cementless highly porous titanium-coated
baseplate implants. Patients were evaluated clinically at postoperative follow-up
visits at a minimum of 5 years. To calculate the survivorship, Kaplan–Meier analysis
was performed to determine all-cause, aseptic, and septic implant survivorship at
each final follow-up for all patients.
Results A total of 228 TKAs were performed and followed for a minimum of 5 years (range,
5–6 years). As of the latest follow-up, one case of septic loosening of the patellar
button and one case of patellar dislodgment secondary to physical manipulation were
recorded and revised. Overall, the cohort displayed implant survivorship of 99.5%
at 5-year minimum follow-up. Improvements were seen in both Knee Society pain and
function scores and were 37 points (range, 17–60 points) and 28 points (range, 15–47
points), respectively. The mean improvement in flexion was 17.8 (range, –20 to 40 degrees)
and mean improvement in extension was –5.5 (range, –30 to 5 degrees).
Discussion Cementless TKAs serve as strong alternative choice to cemented TKAs. Although cemented
fixation is commonly known as the gold standard, results of this study confirm the
findings of previous investigations on the survivorship of cementless TKA implants.
Therefore, patients who undergo primary TKA with a cementless tritanium baseplate
can expect excellent clinical outcomes at a 5-year minimum follow-up.
Keywords
TKA - cementless - outcomes
