Theiner Manish, Mehl Julian, Freund Norbert
Krankenhaus der Barmherzigen Schwestern Ried, 4910, Ried im Innkreis, Österreich.
UWK Donau Krems, Krems, Österreich.
Orthopadie (Heidelb). 2025 Sep 17. doi: 10.1007/s00132-025-04717-5.
The ability to resume sporting activities after total knee arthroplasty (TKA) is a key concern for many patients. While cementless implantation techniques are gaining relevance, long-term data on their impact on physical activity are limited. This study aimed to evaluate individual leisure activities and functional outcomes following cementless TKA over a five-year period.
A retrospective analysis of prospectively collected data was conducted on 42 patients (age 35-80 years) who underwent primary cementless TKA (Attune, DePuy) between April 2017 and April 2018. For each patient, the three most relevant sports were identified using the Knee Society Score (KSS) and compared pre- and postoperatively (1 and 5 years). Additionally, activity-related subscales of the KSS and KOOS (Knee injury and Osteoarthritis Outcome Score) were evaluated. Statistical analyses included Wilcoxon, Friedman, and Spearman correlation tests.
Patient-reported outcome measures (PROMs) showed significant improvements in sports-related performance (p 0.05) at 1 and 5 years postoperatively. Pain during favorite sports decreased from "severe" to "mild." KSS activity subgroups improved from "severe-moderate" to "moderate-mild," and KOOS subgroups from "extreme-severe" to "moderate." KSS and KOOS scores showed strong correlation. No aseptic loosening or periprosthetic infections were observed.ConclusionCementless TKA allows for a sustained return to sporting activity with significant symptom reduction over a five-year period, without increased risk of implant loosening. These findings support realistic patient counseling regarding postoperative expectations.
This study demonstrates that patients benefit long term from a significant improvement in athletic ability after cementless TKA. Recent studies suggest that cementless techniques are not only equivalent to cemented approaches but may even be superior in certain aspects. The low loosening rate further supports the use of cementless TKA in physically active patients.
Cementless TKA allows for a sustained return to athletic activities with a significant reduction in discomfort. No loosening occurred over the 5‑year period. The results of this study can aid in patient counseling to set realistic expectations regarding postoperative athletic performance.
全膝关节置换术（TKA）后恢复体育活动的能力是许多患者的关键关注点。虽然非骨水泥植入技术越来越受到重视，但关于其对身体活动影响的长期数据有限。本研究旨在评估非骨水泥TKA术后五年内的个人休闲活动和功能结果。
对2017年4月至2018年4月期间接受初次非骨水泥TKA（Attune，DePuy）的42例患者（年龄35 - 80岁）进行前瞻性收集数据的回顾性分析。对于每位患者，使用膝关节协会评分（KSS）确定三项最相关的运动，并在术前和术后（1年和5年）进行比较。此外，还评估了KSS和膝关节损伤与骨关节炎疗效评分（KOOS）中与活动相关的子量表。统计分析包括Wilcoxon、Friedman和Spearman相关性检验。
患者报告的结局指标（PROMs）显示，术后1年和5年与运动相关的表现有显著改善（p < 0.05）。最喜欢的运动中的疼痛从“严重”降至“轻度”。KSS活动亚组从“重度 - 中度”改善至“中度 - 轻度”，KOOS亚组从“极重度”改善至“中度”。KSS和KOOS评分显示出很强的相关性。未观察到无菌性松动或假体周围感染。
非骨水泥TKA可使患者在五年内持续恢复体育活动，症状显著减轻，且植入物松动风险未增加。这些发现支持对患者进行关于术后预期的现实咨询。
本研究表明，患者在非骨水泥TKA术后运动能力显著改善，长期受益。近期研究表明，非骨水泥技术不仅等同于骨水泥技术，在某些方面甚至可能更优越。低松动率进一步支持在身体活跃的患者中使用非骨水泥TKA。
非骨水泥TKA可使患者持续恢复体育活动，不适显著减轻。五年内未发生松动。本研究结果有助于对患者进行咨询，以设定关于术后运动表现的现实期望。
