Early Outcomes of Cemented versus Cementless Total Knee Arthroplasty

Abstract

Introduction. Total knee arthroplasty (TKA) has been proven
to be very effective for long-term pain relief in the degenerative
knee. Few studies have investigated short-term clinical
and functional outcomes between the cemented and cementless
TKA. The specific aim of this study was to assess the potential
difference of functional outcomes in the early postoperative
period between these two surgical options using
the Knee Society Score (KSS) and range of motion (ROM).

Methods. A total of 164 knees that had undergone TKA by a single
surgeon 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 KSS
at each visit (1.5 months, 3 months, and 12 months). Two separate
KSS scores were assigned: functional score and clinical score.

Results. Sixty-seven knees underwent cemented TKA and 97
knees underwent cementless TKA. No significant difference
was recognized in either age or body mass index for these
two TKA groups. The cementless group showed a significant
early ROM improvement after 1.5 months post-operative (p <
0.05), while the cemented group showed ROM improvement
only after three months post-operative. No significant difference
was detected in terms of KSS between the cemented and
cementless TKA groups at each measured time period. Both
groups showed marked KSS improvement (cemented: 135%,
cementless: 125%) after 1.5 months post-operative and the
KSS seemed to be stabilized after three months post-operative
for both groups (cemented: p = 0.36; cementless: p = 0.07).

Conclusions. There was a significant early ROM improvement
for the cementless TKA group compared to the cemented
TKA group, but no statistical significant difference was noted
in KSS in the early post-operative period when comparing cemented
and cementless TKA groups. The findings provide evidence
that cementless TKA patients can undergo an identical
post-operative protocol to cemented TKA, without concerns
about implant stability or function. KS J Med 2016;9(4):93-98.