Cementing Techniques in Total Knee Arthroplasty(Review Article)

Aminizadeh, Sina; Bayati, Mehdi; Sahebi, Mahdi; Ayati Firoozabadi, Mohammad; Razzaghof, Mohammadreza; Mortazavi, SM Javad

doi:10.22034/ijos.2025.482173.1110

Cementing Techniques in Total Knee Arthroplasty(Review Article)

Document Type : Review

Authors

sina aminizadeh ¹

Mehdi Bayati ¹

mahdi sahebi ²

Mohammad Ayati Firoozabadi ¹

Mohammadreza Razzaghof ¹

SM Javad Mortazavi ¹

¹ Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

² Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.22034/ijos.2025.482173.1110

Abstract

Abstract
Total Knee Arthroplasty (TKA) is a surgery performed to treat patients with advanced knee osteoarthritis. Currently, about 95.3% of knee arthroplasties are performed using the cemented technique. Since the introduction of Polymethylmethacrylate (PMMA) cement, it has played a primary role in arthroplasty. Cementless fixation may lead to better survival rates in selected patients, while cemented TKA is believed to have lower infection rates. With the increasing number of TKAs, improving cementing techniques is essential to reduce primary TKA failure and avoid revision surgeries. A narrative review was conducted by searching the MEDLINE database from 2000 to 2024 to investigate the most appropriate cementing techniques in knee replacement. Recent studies have identified several factors affecting the results of cement placement in TKA, such as cement penetration depth, cementing technique, and cement viscosity. Preparing the bone surfaces before cementing is essential to ensure adequate cement penetration. Bone surfaces must be thoroughly dried before cementing. For optimal cement penetration, sclerotic surfaces should undergo drilling. Poor cementing technique is associated with loosening of the prosthesis leading to early or late joint replacement failure. Therefore, it is essential to use an accurate cementing method at the time of TKA to avoid aseptic loosening and, early failure of TKA.

Keywords

Total knee arthroplasty, Bone cements, Osteoarthritis

Subjects