Cementless Knee Replacement Could Last Longer

Knee replacement surgery is one of the most effective and predictable orthopedic procedures.  Hundreds of thousands of patients have a knee replacement each year so they can enjoy life pain-free and get back to activities they’ve given up.  

Over the past couple of years, I’ve seen good outcomes with a newer type of “cementless” or uncemented knee replacement. There is reason to believe that this type of implant could last longer than traditional implants that require the use of bone cement. 


The traditional implant used in knee replacement generally lasts a long time—15 to 20 years—but it doesn’t last indefinitely. When the implant wears out or loosens, patients generally need a second knee replacement, known as a revision surgery. The cementless knee replacement could change that. 

In a standard knee replacement, the components of the implant are secured in the joint using bone cement. The technique has worked well for decades. But eventually, over time, the cement starts to loosen from the bone and/or the implant. 

With the new cementless prosthesis, the components are press fit into place for “biologic fixation,” which basically means that the bone will grow into the implant. Perfect positioning of the implant is critical, and we use robotic guidance for pinpoint accuracy. 

With biologic fixation, implant loosening over time would be less likely and a total knee replacement could potentially last much longer, even indefinitely. This is an important consideration, especially for younger or more active patients who put more demands on their joint, causing more wear and tear.

Cementless implants have been used in total hip replacement surgery for many years. Because of the knee’s particular anatomy, it was more challenging to develop a cementless prosthesis that would work well in the knee. But over the past few years, major advances in design, technology and biomaterials have paved the way for a viable cementless knee implant. 

The uncemented knee replacement I utilize is FDA cleared and has been available for the past several years. It can also be used in conjunction with MAKO robotic-assisted surgery, combining two of the most recent knee replacement advancements into one high-tech procedure that aims to benefit patients.

Candidates for the cementless procedure are generally patients under 70 with good bone quality to promote biological fixation. In addition to younger patients, the cementless implant may also prove to be a good option for very overweight patients who tend to put more stress on their joint replacement and have been shown to have an increased risk of loosening with cemented knee replacements. Studies are under way to see how patients with cementless knee replacements do over the long term. 

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