Bull Hosp Jt Dis (2013). 2021 Mar;79(1):6-10.
Cementless fixation in total knee arthroplasty (TKA) offers the potential for biologically active osseointegration and the potential for life-long fixation. With early cementless TKA designs, several design issues were identified related to early failure, particularly with the tibial and patellar components. However, in the recent two decades, with improvements upon the early designs, particularly in porous metal technology as well as improved early biomechanical stability, interest was re-established in cementless TKA. The surgical technique for cementless TKA is more exacting than cemented technique, with an important emphasis on indications, accurate resections, and component alignment. Modern cementless TKA designs have demonstrated excellent early- and mid-term survivorship equivalent to cemented TKA. More long-term studies are needed to study this comparison. While implant cost maybe higher with cementless designs, there is emerging evidence that there may be an overall cost saving with the use of cementless components given the shorter operative time and the savings in the cost of supplies associated with the use of cement. As the population undergoing TKA is becoming younger and more active, interest in the use of cementless implants will likely increase.
非骨水泥固定在全膝关节置换术（TKA）中具有潜在的生物活性骨整合和终身固定的潜力。在早期的非骨水泥 TKA 设计中，发现了几个与早期失败相关的设计问题，特别是与胫骨和髌骨组件有关。然而，在最近的二十年中，随着早期设计的改进，特别是在多孔金属技术以及早期生物力学稳定性的提高，人们对非骨水泥 TKA 的兴趣重新建立起来。非骨水泥 TKA 的手术技术比骨水泥技术要求更高，特别强调适应症、准确的切除和组件对齐。现代非骨水泥 TKA 设计已经证明了在早期和中期与骨水泥 TKA 相当的出色存活率。需要更多的长期研究来研究这种比较。虽然非骨水泥设计的植入物成本可能更高，但有新的证据表明，由于非骨水泥组件的手术时间更短，以及与使用骨水泥相关的供应成本的节省，使用非骨水泥组件可能会总体节省成本。随着接受 TKA 的人群变得越来越年轻和活跃，对使用非骨水泥植入物的兴趣可能会增加。
