Total Knee Arthroplasty Component Selection

Component Fixation

The American Academy of Orthopaedic Surgeons recommends using either cemented or uncemented tibial and femoral components with conventional ultra-high molecular weight polyethylene (UHMWPE) bearing surfaces, as there is no clinically meaningful difference in outcomes, complications, or revision rates between fixation methods or between conventional and highly cross-linked polyethylene, with strong evidence supporting equivalent outcomes between cemented and uncemented fixation methods 1, 2
Moderate evidence shows no difference in complications or revision rates when comparing all-cemented versus all-uncemented femoral and tibial components, with the American Academy of Orthopaedic Surgeons providing guidance on component selection 1, 2
Strong evidence supports using either all-polyethylene or modular tibial components, as outcomes are equivalent, according to the American Academy of Orthopaedic Surgeons 1, 2

Conventional UHMWPE has been the predominant bearing surface since 1962, offering enhanced wear resistance and reduced friction compared to other polymers, with the International Journal of Oral Science providing evidence on the material's properties 3, 4

Strong evidence supports equivalent outcomes between all-polyethylene and modular tibial components, with the American Academy of Orthopaedic Surgeons recommending either option 1, 2

Strong evidence shows no difference in outcomes or complications between posterior-stabilized and posterior cruciate-retaining arthroplasty designs, with the American Academy of Orthopaedic Surgeons providing guidance on design selection 5

The American Academy of Orthopaedic Surgeons provides strong evidence against surgical navigation, patient-specific instrumentation (PSI), and robotic assistance, as they provide no clinical benefit 1, 2, 6

Titanium alloy (Ti-6Al-4V) remains the preferred metal for major orthopedic components due to biocompatibility and bio-integration, according to the International Journal of Oral Science 7
Conventional UHMWPE is the gold standard bearing surface, with a minimum fossa thickness of 4mm recommended, with the International Journal of Oral Science providing evidence on the material's properties 3, 4