Comparing Short-Term Outcomes of Cementless vs. Cemented Fixation in TKA

Cementless total knee arthroplasty (TKA) is becoming a more common alternative to traditional cemented knee replacement, although questions remain about outcomes due to limited data on the cementless option.

At the recent 2022 Annual Meeting of the American Academy of Orthopaedic surgeons, researchers from Hospital for Special Surgery (HSS) presented their findings on survivorship and outcomes for cementless versus cemented procedures in which the same implant design was used.

For the study, the researchers identified 598 primary unilateral TKAs – 170 cementless and 428 cemented – that had been performed at HSS between 2016 and 2018, obtaining demographics, operative details, and information on complications from patients’ medical records.

Patients undergoing the cementless procedure were younger overall, with a mean age of 63, versus 68 for those undergoing a traditional cemented TKA. At 2-year follow-up, no statistically significant differences were observed between groups for:

  • Hospital length of stay, 57 hours for cementless TKA vs 60.5 hours for cemented TKA (P=0.98)
  • Hospital readmission in the first 90 days after surgery, 1.8% for cementless TKA vs
    9% for cemented TKA (P=0.954)
  • Implant survivorship, 96% survivorship for cementless TKA and 95% survivorship for cemented TKA (P=0.419)

Use of the cementless implant reduced operating room time by 25% compared with the cemented TKA, saving an average of 27 minutes (82.6±21.4 minutes for cementless TKA vs 109.1±24.6 minutes for cemented TKA; P< 0.001) .

“The biggest question now is whether or not cementless total knee replacement will have better long-term durability and fixation than cemented knee replacement,” said Brian D. Chalmers, MD, who specializes in hip and knee arthroplasty at HSS and who was a study co-author. “Following these patients to assess long-term outcomes is the next step.”


Alpaugh K, Chiu Y-F, Alioune D, Jerabek SA, Ast MP, Westrich GH, Chalmers B. A Comparison of Cementless vs. Cemented Total Knee Replacement: Minimal Difference in Early Outcomes (Paper 106). Presented at the American Academy of Orthopaedic Surgeons’ 2022 Annual Meeting, March 22-26, 2022, Chicago, Illinois.

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