The Knee, ISSN: 0968-0160, Vol: 27, Issue: 2, Page: 552-557

Convincing long-term results independent from the postoperative leg alignment following cementless total knee arthroplasty

Kaipel, Martin; Klikovics, Joachim; Sinz, Günter; Szabo, Stefanie; Weinoehrl, Sarah; Hausner, Thomas


Cementless primary total knee arthroplasty shows numerous advantages compared with cemented implants (e.g., shorter operation time, preservation of the bone stock). Up to now an increasing number of clinical long-term studies exist. Despite this fact, there is no evidence about the influence of the postoperative leg alignment on the results of cementless knee arthroplasty. There is no work on the clinical outcome of the specific implant, which was used in this study (VANGUARD®, ZimmerBiomet). The purpose of this study was to assess the clinical and radiological long-term results after cementless knee arthroplasty in relation to the postoperative mechanical leg alignment.


Clinical and radiological results were retrospectively assessed in 83 patients at 10.3 years (ranging from 9.6 to 11.8 years) after implantation. Hip-knee-ankle angle (HKA) was measured, and the patients were separated into a corrected (HKA between three degrees of varus and three degrees of valgus, n = 60) and a varus/valgus (HKA > 3° of varus and valgus, n = 23) group.


Up to the time of the clinical follow-up, three out of 83 patients already underwent a revision surgery due to a deep infection (3.6%). Tegner–Lysholm Knee scale was 89.1 in the corrected group and 88.8 in the varus/valgus group (p = .94). The mean Knee Injury and Osteoarthritis Outcome score (KOOS) was 81.2 in the corrected group and 82.4 in the varus/valgus group (p = .63).


Results of this study showed convincing clinical and radiological results after primary cementless knee arthroplasty. Under- or overcorrected postoperative mechanical leg alignments did not influence the long-term clinical results.

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