Cementless knee replacement may reduce the proportion of patients with poor outcomes .

Could cementless fixation improve outcomes for patients at risk of dissatisfaction following total knee arthroplasty? A prospective study of 109 patients compared a 3D-printed titanium cementless implant with an otherwise identical cemented design. At 2 years, 96.3% of cementless recipients achieved an acceptable symptom state compared with 76.4% of cemented recipients, despite similar average joint-awareness scores. These findings suggest that fixation method may influence the proportion of patients experiencing poor outcomes, although the nonrandomized design and small sample limit causal interpretation.