Abstract
Whether cemented or cementless fixation is superior in TKA is a controversial issue. There are few high quality papers assessing the merits and demerits of cementless and cemented fixation and these will be highlighted. Roentgen stereophotogrammetric analysis (RSA) is an important tool to determine early loosening of components after TKA. There is a high correlation between loosening and early migration of implants seen in the first 2 years after surgery. Hence it is a valuable tool to determine the likelihood of failure in studies with short follow up. Meta-analyses that include papers using RSA are therefore the most valuable and these will be summarised.
In view of the fact that the majority of patients undergoing TKA worldwide are low-demand and elderly persons, in view of the higher cost associated with cementless knees, and the equivalence or superiority of results of cemented TKAs with regards to clinical outcomes and survival in the intermediate term, cemented TKA remains the gold standard in the medium term.
