Cementless Versus Cemented Total Knee Arthroplasty

Background: We previously reported the 2-year results of a prospective randomized controlled trial of cementless versus cemented total knee arthroplasty (TKA) implants of the same design. The purpose of the present study was to provide concise results at intermediate-term follow-up. Methods: The original study included 141 TKAs (76 performed without cement and 65 performed with cement). Since then, 8 patients died and 4 withdrew. Of the remaining 129 patients, 127 (98%) were available for analysis. Survivorship analysis was performed; Oxford Knee, Knee Society, and Forgotten Joint Scores were calculated; and radiographs reviewed. Mean follow-up was 6 years. Results: The survivorship free of any revision was 100% in both groups. There were no differences between the groups in any patient-reported functional outcome measure (p = 0.2 to 0.5). However, a higher percentage of patients in the cementless TKA group were either extremely or very satisfied with their overall function (p = 0.01). Radiographically, there was no evidence of implant loosening in either group. Conclusions: At 6 years, there were no differences between cementless and cemented TKA implants of the same design in terms of survivorship, clinical, or radiographic outcomes. Level of Evidence: Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.