The Evolution of Cementless Knee Replacements: A Shift in Surgical Approach
To cement or not: The evolution of partial & total knee replacement
The Times Of India
Image: The Times Of India
Recent advancements in knee replacement surgery suggest a shift towards cementless techniques, allowing patients to engage in high-impact activities post-surgery. The MAKO robot has improved precision in surgeries, potentially reducing complications associated with cement loosening.
- 01Cement loosening is a common failure in artificial knee replacements, primarily due to the polymethylmethacrylate cement used since the 1980s.
- 02The MAKO robot, introduced in 2006, has enhanced the precision of knee surgeries, enabling the use of cementless components for total knee replacements.
- 03Cementless designs, although initially challenging to implement, are now becoming feasible for total knee replacements, allowing for greater patient mobility post-surgery.
- 04Patients with cementless knee replacements can safely return to running and impact sports, with a durability expectation of at least 30 years for the polyethylene component.
- 05Partial knee replacements still face challenges with cementless designs due to their smaller surface area, but advancements are anticipated.
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Over the past 35 years, the approach to knee replacement surgery has evolved significantly, particularly concerning the use of cement. Traditionally, polymethylmethacrylate cement was used to secure knee implants, leading to complications such as loosening at the cement-bone interface. However, advancements in surgical technology, notably the introduction of the MAKO robot, have allowed for more precise bone cuts, facilitating the use of cementless components in total knee replacements. This innovation enables patients to engage in high-impact activities without the fear of loosening, as the components are designed to remain securely in place. Current expectations suggest that these cementless implants can last at least 30 years without wear. While cementless options for partial knee replacements are still under development due to their smaller surface area, some patients are already experiencing significant mobility improvements, with one individual even completing a cross-country run on bilateral partial knee replacements. This shift in surgical practice marks a significant advancement in orthopedic care, emphasizing the importance of exercise and mobility post-surgery.
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The shift towards cementless knee replacements could enhance patient recovery and activity levels, impacting rehabilitation practices.
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