Modern cementless posterior stabilized mobile-bearing total knee arthroplasty shows comparable clinical and radiographical results to its cemented predecessor at 1-year follow-up

Knee Surg Sports Traumatol Arthrosc. 2022 Sep;30(9):3131-3137. doi: 10.1007/s00167-022-07047-7. Epub 2022 Jul 4.


Purpose: The purpose of this study was to evaluate perioperative and short-term clinical and radiographical results of a modern PS mobile-bearing cementless TKA system.

Methods: A retrospective review of a consecutive series of TKAs was performed by a single surgeon using a cementless or cemented TKA of the same design (Attune, DePuy Synthes, Massachusetts, USA). The 2011 Knee Society Score, Forgotten Joint Score-12, Hip-Knee-Ankle angle, and the presence of radiolucent lines (RLLs) were reviewed 1-year postoperatively with 1:1 matching performed for age, gender, body mass index, and preoperative UCLA score. Fisher's exact test or independent Student's t-test were used for statistical analyses.

Results: Forty-five cementless and 45 cemented TKAs were reviewed after 1:1 matching. The mean operative time was 8.8 min shorter (P < .01), and the mean amount of drainage was 40.0 ml greater (P = .04) in the cementless cohort. At 1-year postoperatively, there were no significant differences in both cohorts in 2011 Knee Scores and Forgotten Joint Scores-12, with no patients requiring revision surgery (NS). The incidence of RLLs was significantly higher in cementless TKAs (51%) than that in cemented TKAs (22%, P < .01). However, the mean width of RLLs in the cementless TKAs (0.2 mm) was significantly smaller (P < .01) than that in the cemented TKAs (0.8 mm) at 1-year postoperatively with no progression.

Conclusion: A recently introduced cementless PS mobile-bearing TKA design demonstrated comparable postoperative and radiographical results to its cemented predecessor at 1-year follow-up.

Level of evidence: Retrospective cohort study, Level III.

Keywords: Cementless; Posterior stabilized total knee arthroplasty; Radiolucent line.

MeSH terms

  • Arthroplasty, Replacement, Knee*
  • Bone Cements
  • Follow-Up Studies
  • Humans
  • Knee Prosthesis*
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome


  • Bone Cements