The Journal of Arthroplasty , Volume 33 , Issue 12 , 3672 - 3677

A 9-Year Outcome Study Comparing Cancellous Titanium-Coated Cementless to Cemented Tibial Components of a Single Knee Arthroplasty Design

Karachalios, Theofilos et al.


The cemented Advance Medial-Pivot total knee arthroplasty (TKA) was designed to reflect contemporary knee kinematics data and has shown satisfactory long-term outcomes.


We retrospectively evaluated prospectively collected data from 2 groups of patients. Group A consisted of 54 patients (54 TKAs), 18 men and 36 women, and mean age at surgery was 63.2 ± 5.2 years; group B consisted of 54 patients (54 TKAs), 17 men and 37 women, and mean age at surgery was 63.8 ± 5.1 years. Patients of both groups were matched for age, gender, side, body mass index, and length of follow-up. The cementless components of this design were implanted in group A and the cemented in group B. Implant failure, complication rates, clinical (both subjective and objective) and radiological outcomes were assessed in all patients of both groups.


All patients of both groups were available for final follow-up evaluation at a mean of 8.6 ± 0.4 years. Survival analysis at 9 years showed a cumulative success rate of 100% in both groups with all end points. In neither group were implant-related, surgeon-related, or patient-related failures observed. When both groups were compared, in all time intervals, no differences were recorded on Knee Society system, Western Ontario and McMaster University Osteoarthritis Index, Short Form-12, and Oxford Knee Scores. On radiological examination, for both groups, all parameters evaluated were satisfactory.


This study presents satisfactory midterm clinical and radiological outcomes with the use of both versions of this design. Moreover, no implant-related failures were observed with the use of cancellous titanium-coated tibial implants.

Download article