Cementless Total Knee Arthroplasty: Does Age Affect Survivorship and Outcomes?

Adit R Maniar; James L Howard; Lyndsay Somerville; Brent A Lanting; Edward M Vasarhelyi

doi:10.1016/j.arth.2024.04.027

Cementless Total Knee Arthroplasty: Does Age Affect Survivorship and Outcomes?

J Arthroplasty. 2024 Apr 14:S0883-5403(24)00339-5. doi: 10.1016/j.arth.2024.04.027. Online ahead of print.

Authors

Adit R Maniar¹, James L Howard², Lyndsay Somerville³, Brent A Lanting⁴, Edward M Vasarhelyi⁵

Affiliations

¹ Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Electronic address: aditmaniar@gmail.com.
² Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Electronic address: james.howard@lhsc.on.ca.
³ Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Electronic address: lyndsay.somerville@lhsc.on.ca.
⁴ Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Electronic address: brent.lanting@lhsc.on.ca.
⁵ Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Electronic address: edward.vasarhelyi@lhsc.on.ca.

PMID: 38626864
DOI: 10.1016/j.arth.2024.04.027

Abstract

Background: Despite the growing popularity of cementless total knee arthroplasty (TKA) in younger patients, the outcomes are unclear in the elderly population. We aimed to compare the clinical outcomes and survivorship of cementless TKA between different age groups.

Methods: Utilizing our prospectively collected institutional database, we retrospectively reviewed all patients undergoing primary cementless TKAs at a tertiary care institute. We identified 347 TKA, that were divided into 3 groups based on age at the time of surgery. Group A was ≤ 60 years, Group B was 60 to ≤70 years, and Group C was > 70 years. We compared clinical outcomes (Knee Society Clinical Rating System [KSCRS], Western Ontario and McMaster University Osteoarthritis Index [WOMAC], and Veterans Rand 12 Item Health Survey [VR-12]) and survivorship between the groups.

Results: At final follow-up, range of motion, KSCRS, WOMAC, and VR-12 physical score were comparable (P > 0.05). The VR-12 Mental score was higher in Group B and Group C than in Group A (P = 0.003). Compared to preoperative scores, the change in KSCRS, WOMAC, and VR-12 physical and mental scores was comparable at the final follow-up (P > 0.05). No patient underwent revision for aseptic loosening.

Conclusion: There were no cases of revision surgery for aseptic loosening in our cohort of 347 cementless TKAs. Patients > 70 years of age undergoing cementless TKA can achieve clinical scores equivalent to those of younger patients at short term (2-year) follow-up. Longer-term survivorship is still required, but based on early data, cementless TKA can be a safe option for older patients.

Keywords: Age; Cementless; Outcomes; Survivorship; Total Knee Arthroplasty.