Alfred J. Tria Jr.
PARK CITY, Utah — Despite published studies that reported good long-term survival of total knee arthroplasty implants with either cementless or cemented fixation, cementing in TKA is a more versatile procedure with results that do not show late implant or fixation failure, according to a presentation at the Joint Arthroplasty Mountain Meeting.
Alfred J. Tria Jr. , MD, said that using cemented TKA implants allows the surgeon to control many factors of the procedure, including achieving the ideal doughy state of the cement at the right time, which is what most surgeons prefer in cemented TKA.
However, Tria mentioned in his presentation, which was part of a debate with Aaron M. Hofmann, MD, some favorable features of cementless TKA that are starting to gain his attention. Among them, he said, is that the quality and quantity of literature on cementless TKA is improving.
“It may very well be something for the future but, right now, I think cement is for every knee,” Tria said.
For someone who is just beginning to use cementless TKA, there are barriers to consider, he said.
“It is cost [and] the learning curve. You have to pick the right patient; and changing your postoperative management,” according to Tria.
“Stick with the gold standard, at least for this period of time, and you’ll probably be safer,” he said. – by Susan M. Rapp
Tria AJ. Cement remains the gold standard with no reason to change. Presented at: Joint Arthroplasty Mountain Meeting; Feb. 10-13, 2019; Park City, Utah.
Disclosure: Tria reports he receives IP royalties from and is a paid consultant for Smith & Nephew and receives publishing royalties, financial or material support from Springer.