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Cementless mobile-bearing UKA shows noninferior survivorship and clinical scores to cemented devicesCementless implants show similar results to cemented knee replacements

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Key Takeaway
Note that cementless mobile-bearing UKA is noninferior to cemented devices in survivorship and clinical scores.

This multicenter randomized controlled trial enrolled 378 patients undergoing unicompartmental knee arthroplasty (UKA) to evaluate the noninferiority of a cementless mobile-bearing device compared to a cemented device. The study was a single-blind investigation with follow-up periods at 2 years and 5 years.

At 2 years, survivorship was 94.0% for the cementless group (95% CI 89.9 to 96.8) and 97.5% for the cemented group (95% CI 93.0 to 99.5), with no statistical difference (P = 0.19). At 5 years, survivorship was 91.7% for the cementless group (95% CI 86.4 to 95.0) and 95.6% for the cemented group (95% CI 88.4 to 98.4; P = 0.24). Radiographic success was noninferior, with 93.8% in the cementless group versus 97.4% in the cemented group (P = 0.19).

Functional outcomes at 2 years showed no significant differences between groups. The Knee Society function score was 89.9 ± 13.0 for cementless versus 89.8 ± 14.0 for cemented (P = 0.95). The Knee Society clinical assessment score was 95.5 ± 8.5 for cementless versus 95.6 ± 6.9 for cemented (P = 0.92).

Safety data and specific adverse event rates were not reported. The study was limited by a single-blind design. These results suggest that cementless mobile-bearing UKA provides comparable clinical and radiographic outcomes to cemented alternatives for patients with knee osteoarthritis.

How this fits prior evidence

How this fits prior evidence: This study addresses a gap in surgical options for knee osteoarthritis by providing evidence on device types. While prior coverage noted that moderate-intensity isotonic exercise improves function by MD -16.66 and digital support for exercise improves physical function, this study focuses on the surgical management of the condition. It provides a specific comparison of cementless versus cemented hardware for unicompartmental knee arthroplasty.

Living with knee osteoarthritis can make every step feel like a chore. For some patients, a partial knee replacement (called a unicompartmental knee arthroplasty) is the chosen path to regain mobility. A major question for these patients and their doctors is whether a cementless implant—one that stays in place without bone cement—works as well as the traditional cemented method.

Researchers followed 378 patients to find out. They compared a cementless mobile-bearing device against a standard cemented one. After following the patients for up to five years, the results showed that the cementless option was not inferior to the cemented one. Both groups reported similar success in how the joints looked on X-rays and how well the patients could move and function in their daily lives.

While the study was single-blind, meaning the researchers did not know which patient had which implant during the assessment, the data suggests both methods are reliable. At the two-year and five-year marks, the survivorship rates and clinical scores were nearly identical between the two types of implants. Talk to your doctor to see which option best fits your specific needs.

What this means for you:
Cementless and cemented partial knee replacements show nearly identical results for patient mobility and durability.

Common questions

Is a cementless knee implant as durable as a cemented one?

Yes, the study found no significant difference in survivorship between the two. At two years, 94.0% of cementless implants survived compared to 97.5% for cemented ones. At five years, the rates were 91.7% for cementless and 95.6% for cemented. Both results were statistically similar.

Do patients feel better with cementless implants?

Patients reported very similar results for both types of implants. At the two-year mark, the Knee Society function scores were nearly identical (89.9 for cementless versus 89.8 for cemented). Clinical assessment scores were also almost the same for both groups.

How did the X-rays look for both types of implants?

The study found that the cementless device was not inferior in radiographic success. At the follow-up points, the X-ray results for the cementless implants were comparable to those of the cemented implants, showing both types performed well on imaging.

Study Details

Study typeRct
Sample sizen = 241
EvidenceLevel 2
Follow-up24.0 mo
PublishedOct 2026
View Original Abstract ↓
BACKGROUND: Cementless implants have seen a resurgence in knee arthroplasty to improve long-term bone fixation. The purpose of this study was to report the results of the US Investigational Device Exemption study comparing the mobile bearing cementless and cemented unicompartmental knee arthroplasty (UKA). METHODS: A single-blind, multicenter, randomized controlled trial was performed to compare a medial cementless and cemented UKA implant. There were 378 patients allocated 2:1 to receive the cementless (n = 241) or cemented (n = 137) device between November 2013 and November 2018. The primary end points were identified to demonstrate noninferiority of the cementless device in terms of survivorship, radiographic results, and Knee Society Clinical Assessment and Functional Scores. RESULTS: There was no statistical difference in Kaplan-Meier 2-year survivorship between the cementless (94.0%, 95% confidence interval [CI] 89.9 to 96.8) and cemented cohorts (97.5%, 95% CI: 93.0 to 99.5, P = 0.19); similar survival persisted at five years (91.7%, 95% CI: 86.4 to 95.0 versus 95.6%, 95% CI: 88.4 to 98.4, P = 0.24). Examination of radiographic success revealed noninferior performance of the cementless prosthesis (93.8 versus 97.4%, P = 0.19). Knee Society function (89.9 ± 13.0 versus 89.8 ± 14.0, P = 0.95) and clinical assessment (95.5 ± 8.5 versus 95.6 ± 6.9, P = 0.92) scores at two years demonstrated no differences between groups. CONCLUSIONS: The cementless mobile bearing UKA demonstrated noninferior clinical and radiographic outcomes compared to the cemented device in this US Investigational Device Exemption study. Cementless fixation may be an attractive option for appropriately selected patients.
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