title: Cementless vs Cemented Tibial Fixation in Primary Total Knee Arthroplasty.
abstract: The ideal fixation for modern tibial components in total knee arthroplasty (TKA) remains controversial with uncertainty on whether cementless implants can yield equivalent outcomes to cemented fixation in early follow-up.
  
  
  
  A series of 70 consecutive cases with reverse hybrid cementless fixation were matched to 70 cemented cases from 2008 to 2015 based on implant design and patient demographics.
  
  
  
  Cementless TKA demonstrated greater aseptic loosening (7 vs 0, P = .013) and revision surgery (10 vs 0, P = .001) than cemented fixation within 5 years of follow-up, but with no clinically significant differences in outcome scores.
  
  
  
  It remains unclear whether early aseptic loosening in cementless TKA can be reduced with enhanced adjunct fixation and what proportion of early failure justifies the potential lifelong fixation through biologic ingrowth of cementless tibial components.
authors.affiliation: Department of Orthopaedics, Rush University Medical Center, Chicago, Illinois; Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, New York.
authors.forename: Omar A
authors.initials: OA
authors.lastname: Behery
authors.affiliation: Department of Orthopaedics, Rush University Medical Center, Chicago, Illinois.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Kearns
authors.affiliation: Department of Orthopaedics, Rush University Medical Center, Chicago, Illinois.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Rabinowitz
authors.affiliation: Department of Orthopaedics, Rush University Medical Center, Chicago, Illinois.
authors.forename: Brett R
authors.initials: BR
authors.lastname: Levine
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods*; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design / Q000379:methods*; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D013635:Tantalum / Q000737:chemistry; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D013635:Tantalum
keywords: cementless tibia; porous tantalum; porous titanium and aseptic loosening; reverse hybrid; total knee arthroplasty