¹Presley T, ¹Eapen P, ¹Stoltz M, ¹Granade M, ²Smith L, ¹Yakkanti M, ¹Malkani A
¹University of Louisville, Louisville, KY, USA; ²UofL Health, Louisville, KY, USA

INTRODUCTION:
Total Knee Arthroplasty (TKA) using advanced technology provides accurate bone cuts along with achieving the desired alignment and well-balanced gaps. Cementless TKA provides biologic fixation for long-term survivorship. Purpose of this study was to evaluate outcomes of primary cementless TKA using intraoperative advanced technology.

METHODS:
This was an IRB approved retrospective study from a single institution of 400 consecutive primary, cementless TKAs using advanced intraoperative technology with minimum 2-year follow-up (27.2 months  7.4). 12 patients were lost to follow-up, leaving 388 (97%) for review. All procedures were performed using the same cementless implant design, anesthesia and postoperative protocols. Demographic data included age (64.8 years  9.7), gender (173 males, 227 females), and BMI (32.4 kg/m2  6.3). Outcome measures included Knee Society Scores (KSS), KOOS Jr., Forgotten Joint Score (FJS-12), overall satisfaction (5-point Likert scale), and complications. Statistics were performed using T-test.

RESULTS:
There was a significant improvement in KSS Function scores (49 to 86, p= <0.001); KSS Knee scores (44 to 93, p= <0.001); mean KOOS Jr. score was 85.0 &#61617; 15.8; Mean FJS-12 score was 68.4 &#61617; 29.1; and 92% patient satisfaction at 2 years. 9 (2.25%) patients underwent revision: instability (5), infection (1), arthrofibrosis (1), traumatic arthrotomy (1), well-fixed TKA revised for pain at outside facility (1), and no revisions for aseptic loosening. Other complications included 27 (6.6%) manipulations for stiffness; 13 (3.3%) arthroscopy for capsulitis; and 5 (1.25%) arthrotomy I&D.

CONCLUSIONS:
Primary TKA performed using both cementless implants for long-term biologic fixation and advanced technology with the ability to provide accurate bone cuts, the target limb alignment and well-balanced gaps, led to 97.6% survivorship with no cases of aseptic loosening with significant improvement in PROMs. The use of cementless TKA along with the use of advanced technology appears to be a promising combination.