Survivorship of 500 Cementless Total Knee Arthroplasties in Patients under 55 Years of Age

Published:October 26, 2022DOI:



      With respect to survivorship following total knee arthroplasty (TKA), joint registries consistently demonstrate higher revision rates for both sexes in those less than 55 years of age. The current study analyzed the survivorship of 500 cementless TKAs performed in this age group in a high-volume primary joint unit where cementless TKA has traditionally been used for the majority of patients.


      This was a retrospective review of 500 consecutive TKAs performed in patients under the age of 55 years between March 1994 and April 2017. The primary outcome measures for the study were survivorship and all-cause revisions. Secondary outcome measures included non-revision procedures, clinical, functional, and radiological outcomes.


      An all-cause survival rate of 98.4% and an aseptic survival rate of 99.2% at a median time of 10.7 years (IQR 7.3-14.9, Range 0.2-27.7) was found. Four patents were revised for infection, 2 for stiffness, 1 for aseptic loosening of the tibial component, and 1 for a patella that was resurfaced for anterior knee pain. Thirty-four patients (6.8%) had a non-revision procedure with manipulation under anesthetic (MUA) accounting for 27. On multivariate analysis, pre-operative ROM and female gender were negatively associated with postoperative range of motion (p<0.001 and p=0.003, respectively). Sixty-seven patients (17.3%) had RLL’s and on multivariate analysis, there were no significant predictors of radiolucent lines.


      Cementless TKA in the young patient can achieve excellent clinical and functional outcomes. At a median of 10.7 years, aseptic revision rates are exceptionally low at 0.8% for the entire cohort.


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