Cementless Total Knee Arthroplasty Matches Cemented Survivorship at Five Years

Total knee arthroplasty remains the definitive intervention for end-stage osteoarthritis, yet the optimal method for component fixation continues to be a subject of clinical debate as patient demographics shift toward younger, more active individuals [1]. While cemented fixation has historically served as the gold standard, the leading causes of revision surgery, such as aseptic loosening (the failure of the bond between the implant and bone without infection) and periprosthetic joint infection, drive the search for more durable interfaces [2]. Surgeons are increasingly managing patients with higher body mass indices and complex comorbidities, factors that can significantly influence postoperative quality of life and implant longevity [3, 4]. Although technological adjuncts like robotic assistance and kinematic alignment (a surgical approach that restores the patient's native joint line and rotational axes) have refined surgical precision, the fundamental stability of the bone-implant interface remains the primary determinant of long-term success [5, 6]. This study provides a mid-term comparison of cemented and cementless fixation to determine if contemporary porous metal designs can match the established reliability of the cemented technique.