Cementless total knee arthroplasty: Patient selection and surgical techniques to optimize outcomes

Cementless fixation is a reliable, durable fixation option for patients undergoing primary TKA and is especially attractive for younger and more active patients. Advances in fixation materials such as modern highly porous metals provide an additional adjunct in promoting osseointegration and longer-term success. Proper patient selection, adequate exposure, meticulous surgical technique, and modern implant designs are significant factors for enacting a successful outcome. This article outlines the essential elements and details the surgical techniques that should be considered to facilitate optimal results when utilizing cementless fixation in TKA.