Our Summary

This research paper is a review of studies about cementless knee implants. The authors looked at both older and newer designs of these implants, the results from using newer designs, the risks and benefits, and compared cementless implants to those that use cement. They analyzed 31 studies that were published between January 2010 and April 2017. The review found that the latest designs of cementless knee implants have been very successful. They work well, patients are happy with them, and they last a long time - regardless of the patient’s age. In comparison to implants that use cement, the newer cementless designs may have added advantages. However, more research is needed to confirm these findings, especially research that looks at long-term results.

FAQs

  1. What are the differences between newer cementless implants and original cementless implants for knee replacement?
  2. How do the outcomes of newer cementless total knee arthroplasties compare to those of cemented total knee arthroplasties?
  3. What are the potential benefits and risks associated with the newer cementless total knee arthroplasties?

Doctor’s Tip

One helpful tip a doctor might tell a patient about knee replacement is to follow a recommended post-operative rehabilitation program to help improve strength, flexibility, and range of motion in the knee. This can help optimize the outcome of the surgery and improve overall function and mobility in the long term. Additionally, maintaining a healthy weight and staying active with low-impact exercises like swimming or cycling can also help protect the new knee joint and prevent complications.

Suitable For

Patients who are typically recommended for knee replacement surgery include those with severe knee pain and stiffness that limits daily activities, such as walking, climbing stairs, and getting in and out of chairs. Other factors that may indicate the need for knee replacement surgery include:

  • Severe arthritis or joint damage
  • Failure to respond to conservative treatments such as physical therapy, medications, or injections
  • Significant limitations in range of motion
  • Inability to sleep due to knee pain
  • Significant deformity or instability in the knee joint

It is important for patients to discuss their symptoms and medical history with their orthopedic surgeon to determine if knee replacement surgery is the best treatment option for them.

Timeline

  • Pre-surgery: The patient experiences chronic knee pain, stiffness, swelling, and limited mobility due to conditions such as osteoarthritis or injury. They may have tried conservative treatments like medication, physical therapy, and injections with little relief.

  • Consultation and decision-making: The patient consults with an orthopedic surgeon who recommends knee replacement surgery as a viable option. The patient and surgeon discuss the risks, benefits, and expectations of the procedure.

  • Pre-operative preparation: The patient undergoes pre-operative tests and assessments to ensure they are healthy enough for surgery. They may also attend pre-operative education sessions to learn about the procedure, recovery process, and rehabilitation.

  • Surgery: The patient undergoes knee replacement surgery, where the damaged portions of the knee joint are removed and replaced with an artificial implant. The surgery can be performed using a cemented or cementless technique, depending on the surgeon’s preference and the patient’s condition.

  • Post-operative recovery: The patient stays in the hospital for a few days for monitoring and initial rehabilitation. They begin physical therapy exercises to regain strength, flexibility, and range of motion in the knee. Pain management techniques are used to control post-operative pain.

  • Follow-up appointments: The patient has regular follow-up appointments with their surgeon to monitor their progress, address any concerns, and make adjustments to their rehabilitation plan. X-rays may be taken to assess the implant’s positioning and stability.

  • Long-term outcomes: Over time, the patient experiences improved knee function, reduced pain, and increased mobility. They are able to return to their daily activities and enjoy a better quality of life. The longevity and success of the knee replacement depend on factors like the patient’s overall health, adherence to rehabilitation, and implant design.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a knee replacement surgery with a cementless implant compared to a cemented implant?
  2. How long can I expect the newer cementless implant to last compared to traditional cemented implants?
  3. What are the potential complications or drawbacks associated with a cementless knee replacement?
  4. How soon after surgery can I expect to return to normal activities with a cementless knee replacement?
  5. Are there any specific rehabilitation protocols or precautions I should follow with a cementless knee replacement?
  6. What type of follow-up care and monitoring will be necessary after the surgery with a cementless implant?
  7. Are there any specific factors or conditions that would make me a better candidate for a cementless knee replacement compared to a cemented one?

Reference

Authors: Newman JM, Sodhi N, Khlopas A, Sultan AA, Chughtai M, Abraham R, Oh J, Molloy RM, Harwin SF, Mont MA. Journal: Orthopedics. 2018 Sep 1;41(5):263-273. doi: 10.3928/01477447-20180815-05. Epub 2018 Aug 21. PMID: 30125035