Short-Term Outcomes Following Cemented Versus Cementless Robotic-Assisted Total Knee Arthroplasty

Background: Cemented fixation during total knee arthroplasty (TKA) has long been the gold standard due to excellent survivorship and clinical outcomes. With recent biomaterial advancements, cementless fixation has gained renewed interest. Most studies demonstrate similar clinical outcomes and survivorship between these two fixation methods, without consensus regarding the optimal method of fixation during TKA. Outcomes following TKA also depend upon the proper alignment and positioning of components. Robotic-assisted TKA has been shown to improve outcomes related to component positioning, overall lower limb alignment, and soft tissue balancing. No study to date has investigated the role of robotic-assisted surgery on postoperative outcomes following cementless versus cemented TKA. Methods: This is a retrospective cohort study of patients 18 years of age and older who underwent primary robotic-assisted TKA performed by a single fellowship-trained arthroplasty surgeon. Oxford Knee Scores and Short Form Health Survey scores were obtained preoperatively and at a two-year follow-up. Complications such as DVT, infection, arthrofibrosis requiring manipulation, and revision surgery were collected. Results: Three hundred eighty knees in the cementless cohort and 72 cemented knees were included for analysis. There were no statistically significant differences between the two cohorts in terms of SF-12, Oxford Knee Scores, complications, or revision surgery rates. Conclusion: Cementless fixation during TKA offers an alternative to cemented fixation with similar short-term results in terms of patient-reported outcomes, complication rates, and revision surgery rates. Further research is warranted to better understand long-term outcomes and survivorship following cementless versus cemented fixation during robotic-assisted TKA.