Practice Policy Update regarding COVID-19

Understanding your Surgery: Cemented vs. Cementless Total Knee Replacement

Understanding your Surgery: Cemented vs. Cementless Total Knee Replacement
Understanding your Surgery: Cemented vs. Cementless Total Knee Replacement

Are you one of the millions of American who will undergo knee replacement this year? Knee replacement surgery is a common surgery with a high satisfaction rating among my patients.

Educating my patients on their procedure is an important pillar of my practice. Afterall, educated patients have better outcomes.

My patients often want to know the difference between a Cemented or Cementless total knee replacement.

There are two methods to hold the knee prosthesis in place and bond the implant to your bone. One method uses bone cement and one does not. Some surgeons use a combination of both methods.

Cemented Knee Replacement:

The device provides a surface that is cemented to the bone using a special cement that bonds the patient's natural bone with the prosthetic.

Cementless Knee Replacement:

Instead of using bone cement, these devices have a unique textured surface that encourages new bone growth and assists the bone in growing into the implant for fixation.

Advantages to Cementless Prosthetic:

  • Cementless total knee replacement, also known as press-fit, may have a benefit over cemented implants, specifically for younger joint replacement patients and larger patients.
  • Cementless components offer a better long-term bond between the prostheses and bones.
  • Cementless eliminates the concern for a breakdown in cement.
  • Cementless implants use the patient's natural bone to hold the implants in place; they will last longer and form a more permanent bond with the patient's bones than cemented implants.

Advantages of Cemented Prosthetic:

  • Bone cement allows a surgeon to affix prosthetic joint components to a slightly porous bone from osteoporosis.
  • Bone cement has been around longer, and the longevity is well known, lasting 10-20 years.
  • Cemented implants may be a better option for patients with poor-quality bone due to conditions like osteoporosis and have less chance of healthy bone regrowth.
  • The bone cement dries within 10 minutes of application, so soon as the surgery is complete, the implant is securely in place.

The type of the component(s) used will depend on the patient's history, the patient's diagnosis and the surgeon's recommendation. A thorough examination and medical history are necessary to determine which type of knee replacement implant is right for you.

Dr. Paul Jacob is a hip and knee surgeon in Oklahoma City, and a pioneer of robotic joint replacement surgery. Dr. Jacob has been published in The Journal of Knee Surgery, Journal of Orthopedics, Journal of Pediatric Orthopedics, Arthritis & Rheumatology, and The Orthopedic Journal of Sports Medicine.