Volume VI, Number 1 | March 2022

Results of Cementless Total Knee Arthroplasty Using Advanced Technology: A Review of 400 Cases

1Presley T, 1Eapen P, 1Stoltz M, 1Granade M, 2Smith L, 1Yakkanti M, 1Malkani A
1University of Louisville, Louisville, KY, USA; 2UofL Health, Louisville, KY, USA

Total Knee Arthroplasty (TKA) using advanced technology provides accurate bone cuts along with achieving the desired alignment and well-balanced gaps. Cementless TKA provides biologic fixation for long-term survivorship. Purpose of this study was to evaluate outcomes of primary cementless TKA using intraoperative advanced technology.

This was an IRB approved retrospective study from a single institution of 400 consecutive primary, cementless TKAs using advanced intraoperative technology with minimum 2-year follow-up (27.2 months  7.4). 12 patients were lost to follow-up, leaving 388 (97%) for review. All procedures were performed using the same cementless implant design, anesthesia and postoperative protocols. Demographic data included age (64.8 years  9.7), gender (173 males, 227 females), and BMI (32.4 kg/m2  6.3). Outcome measures included Knee Society Scores (KSS), KOOS Jr., Forgotten Joint Score (FJS-12), overall satisfaction (5-point Likert scale), and complications. Statistics were performed using T-test.

There was a significant improvement in KSS Function scores (49 to 86, p= <0.001); KSS Knee scores (44 to 93, p= <0.001); mean KOOS Jr. score was 85.0 &#61617; 15.8; Mean FJS-12 score was 68.4 &#61617; 29.1; and 92% patient satisfaction at 2 years. 9 (2.25%) patients underwent revision: instability (5), infection (1), arthrofibrosis (1), traumatic arthrotomy (1), well-fixed TKA revised for pain at outside facility (1), and no revisions for aseptic loosening. Other complications included 27 (6.6%) manipulations for stiffness; 13 (3.3%) arthroscopy for capsulitis; and 5 (1.25%) arthrotomy I&D.

Primary TKA performed using both cementless implants for long-term biologic fixation and advanced technology with the ability to provide accurate bone cuts, the target limb alignment and well-balanced gaps, led to 97.6% survivorship with no cases of aseptic loosening with significant improvement in PROMs. The use of cementless TKA along with the use of advanced technology appears to be a promising combination.

The Journal of the American Osteopathic Academy of Orthopedics

Steven J. Heithoff, DO, FAOAO

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Authors in This Edition

J. Michael Anderson BS, OMS IV
Rigel Bacani BA, BS, OMS II
David Beckett OMS I
Bhakti Chavan MBBS, MPH
Jake Checketts DO
Grant Chudik OMS II
Adam Dann
Marc Davidson MD
Clinton J. Devin MD
Jeffrey Dulik DO
Bryan Dunford BS, OMS II
Diego Galindo DO
Gregory Galvin DO
Curtis Goltz DO

Jordan Grilliot DO
Brian Handal
Safet Hatic
Scott Dean Hodges DO
David Houserman DO
Jenna Jarrell MS IV
Michael Jones DO
Anthony Kamson DO
Tyler Metcalf MS IV
Anna Elisa Muzio DO
Cesar Cornejo Ochoa OMS I
Brandi Palmer MS
Joseph Patrick
David Phillips DO

Jonathan Phillips MD
Kornelis Poelstra MD
Jesse Raszewski DO, MS
Katherine Sage DO
Steven Santanello DO, FAOAO
Jared Scott DO
Julieanne Sees
James Seymour DO
Jonathan Schneider DO
John Alex Sielatycki MD
Benjamin Taylor MD, FAAOS
Trevor Torgerson BS, OMS IV
Phong Truong DO
Matt Vassar PhD