Cement versus cementless total knee replacement: is there a place for cementless fixation in 2001?

Secure fixation of components to bone is necessary for the long-term durability of total knee arthroplasty. Stereophotogrammetric and biomechanical studies have shown that cemented tibial components provide for the least amount of subsidence. The medium term results (5–10 years) of a variety of cementless total knee components have shown a higher rate of failure than cemented components. However, certain designs of cementless total knee components are relatively successful and have fewer complications. Retrospective studies comparing cementless with cemented total knee arthroplasty have shown a significantly higher rate of femoral and tibial component loosening and osteolysis. A prospective randomized study of cementless versus cemented components demonstrated no advantage to the more expensive cementless components. The gold standard for total knee arthroplasty in 2001 remains a cemented tricompartmental arthroplasty.