Abstract
The impact of cementless trabecular metal (TM) implants on implant survivorship are
not well delineated. This study compares primary total knee arthroplasty (TKA) revision
rates of cemented knee replacements with two cementless knee replacement designs—cementless
TM and a non-TM cementless design. Data from a national registry queried TKA procedures
performed for osteoarthritis from 1999 to 2020. The risk of revision of Zimmer NexGen
TKA using cementless TM, cementless non-TM, and cemented non-TM were compared. Analyses
included Kaplan–Meier estimates of survivorship and Cox hazard ratios (HR), stratified
by age and gender. Cementless TM components had higher risks of revision compared
with cementless non-TM implants (HR = 1.49; p ≤ 0.001). Cementless TM implants showed higher risks of revision compared with cemented
non-TM prostheses for the first 2 years (HR = 1.75, p < 0.001). Non-TM prostheses posed equal risk of revision for cementless and cemented
fixations (HR = 0.95, p = 0.522). Patients aged 55 to 64 years and 65 to 74 years had a higher risk of revision
for cementless TM compared with cementless non-TM (HR = 1.40, p = 0.033 and HR = 1.79, p < 0.001, respectively) and cemented non-TM implants (HR = 1.51, p < 0.001 and HR = 1.54, p < 0.001, respectively). The study shows there is an increased risk of revision with
TM cementless implants for patients aged 55 to 74 years. These results do not support
the use of TM tibial implants for patients of this age group for primary TKA.
Keywords
arthroplasty - trabecular metal - cemented knee
