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Purpose: Cemented unicompartmental knee arthroplasty (UKA) is a widely used procedure in the treatment of anteromedial and lateral knee osteoarthritis. However, several advantages are reported for cementless UKA, such as improved osseointegration, reduced cement-related costs and complications. The aim of this study was to analyse clinical outcomes, survival, complications, failures and revision rate of cementless UKA.
Methods: A systematic review was performed on 31 May 2024, on PubMed, Cochrane Library and Scopus. We included randomised clinical trials and prospective and retrospective studies reporting clinical outcomes, implant survival, complications, failures and revision rates of cementless UKA. The following data were extracted: study design, type of implant, number of patients and knees, follow-up, age, sex, pre-operative and post-operative clinical outcomes, reoperations and revisions with causes of failure and overall survival.
Results: Fifteen studies were included, involving 3475 patients and 3641 UKA (2568 cementless UKA and 854 cemented UKA). The mean patients' age was 66 years. The mean follow-up was 6.5 years. The Oxford Knee Score improved from 17.8 preoperatively to 40.3 post-operatively in cementless UKA. Knee Society Score improved from 118.2 preoperatively to 168.6 post-operatively in cementless UKA. The reoperation rate was 3.85% for cementless UKA and 9% for cemented UKA. The most common causes of revision were osteoarthritis progression (1.4%), aseptic loosening (0.8%), bearing dislocation and unexplained pain (0.7%). The overall survival of cementless UKA was 96.2% and 93.6% at 5 and 10 years, respectively.
Conclusion: Cementless UKA is a viable alternative to cemented UKAs with a low failure rate, without a lower clinical benefit at a minimum follow-up of 4.2 years.
Level Of Evidence: Level III, systematic review of studies.
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http://dx.doi.org/10.1002/jeo2.70253 | DOI Listing |
J Arthroplasty
August 2025
Orthopaedic Clinic Paulinenhilfe, Diakonie-Klinikum, Stuttgart, Germany; Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany. Electronic address:
Background: Osteonecrosis (ON) of the knee commonly affects the medial femoral condyle, leading to secondary unicompartmental arthritis. While most studies on unicompartmental knee arthroplasty (UKA) in patients who have ON focus on cemented fixation, the outcomes of cementless UKA remain unknown. This study evaluated survival, functional and radiological outcomes, and assessed potential differences for cemented and cementless medial mobile-bearing UKA in patients who had ON.
View Article and Find Full Text PDFArch Orthop Trauma Surg
June 2025
Department of Orthopedic Surgery and Sports Medicine, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France.
Introduction: Cementless fixation of medial unicompartmental knee arthroplasty (UKA) is attracting growing interest as a way to improve implant survival. This study aimed to evaluate the near-decade results, survivorship, and revision causes for a fixed-bearing cementless fully 3D printed UKA.
Materials And Methods: From 2011 to 2014, 168 consecutive cementless UKA implants on 165 patients had been performed in our hospital using a fixed bearing implant with a 3D printed Hydroxyapatite coated ingrowth surface both on the femoral and tibia components.
Purpose: Cemented unicompartmental knee arthroplasty (UKA) is a widely used procedure in the treatment of anteromedial and lateral knee osteoarthritis. However, several advantages are reported for cementless UKA, such as improved osseointegration, reduced cement-related costs and complications. The aim of this study was to analyse clinical outcomes, survival, complications, failures and revision rate of cementless UKA.
View Article and Find Full Text PDFCureus
March 2025
Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN.
Introduction Cementless Oxford unicompartmental knee arthroplasty (OUKA) has been shown to have less frequent radiolucent lines and equivalent or even better results than those of cemented OUKA. However, tibial fractures are more frequent in cementless OUKA than in cemented OUKA, especially in Asian countries. A hybrid option, with a cementless femur and cemented tibia, may, therefore, be a good compromise.
View Article and Find Full Text PDFBone Joint J
March 2025
Department of Orthopaedic Surgery, Medical Clinic Velsen, Velsen-Noord, Netherlands.
Aims: The primary objective of this study was to compare short-term implant survival between cemented and cementless fixation for the mobile-bearing Oxford medial unicompartmental knee arthroplasty (UKA) across various age groups. The secondary objectives were to compare modes of failure and to evaluate patient-reported outcomes.
Methods: A total of 25,762 patients, comprising 8,022 cemented (31.