Enhanced improvement and comparable survivorship in cementless versus cemented total knee arthroplasty: a 2-year analysis of patient reported outcomes and 5-year analysis of implant survivorship.

PURPOSE

This study aimed to evaluate patient-reported outcomes, functional recovery, satisfaction, and implant survivorship for cementless and cemented TKA.

METHODS

A prospective, non-randomized, multicenter study was conducted on 453 patients. Cohort 1 (n = 373 knees) received a fully cementless construct with the Triathlon Tritanium Tibial Baseplate, Triathlon Tritanium Patella, Triathlon CR or PS Beaded Femur with Peri-Apatite, and the Triathlon Tibial Insert. Cohort 2 (n = 147 knees) received a fully cemented construct with identical implant design. Oxford Knee Score (OKS), 2011 Knee Society Score (KSS), and Short Form 12 scores were recorded preoperatively and at 6 weeks, 6 months, 1 year, and 2 years postoperatively. Implant survivorship and adverse events were also recorded.

RESULTS

OKS (mean difference [MD] 1.5, p = 0.0123), KSS Symptoms for pain (with level walking [MD 0.62, p = 0.0007]; with stairs or incline [MD 0.85, p = 0.0037), KSS Patient satisfaction (MD 2.31, p = 0.0004), and KSS Functional Activities (MD 0.53, p = 0.0108) were significantly greater in Cohort 1 out to 2 years postoperatively. The Kaplan-Meier estimated all-cause survivorship was 98.2% (95% CI: 95.7-99.3%) for Cohort 1 and 97.5% (95% CI: 92.6-99.2%) for Cohort 2 (p = 0.4366).

CONCLUSION

Cementless TKA exhibited similar or greater patient outcomes, satisfaction, and function up to 2 years postoperative, while both cohorts showed comparable rates of adverse events and survivorship at 5-year follow-up. This evidence underscores the clinical value and safety of cementless TKA.