Cementless PSI TKA: Optimizing efficiency

Early clinical results with Patient Specific Instrumentation and the NexGen or Persona Trabecular Metal total knee arthroplasty designs have been promising across a broad range of patient subsets in the author׳s practice. More than 800 patients have cementless fixation of NexGen or Persona Trabecular Metal tibial and patellar components, with one aseptic tibial component failure at two years postoperative, one infection at three years postoperative, and two intraoperative patellar fractures that were repaired and healed without sequelae. OR time has been reduced by 10–15 minutes per case with this surgical technique. These clinical findings support published studies indicating that alignment accuracy improves with Patient Specific Instrumentation, and cementless fixation with tantalum porous metal-to-bone surface engagement is more stable than porous-coated or cemented implants. Successful application of these technologies may address malalignment and implant fixation issues that cause a high rate of failure in primary knee arthroplasty.