{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T01:52:24Z","timestamp":1784857944632,"version":"3.55.0"},"reference-count":41,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["arthroplastytoday.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroplasty Today"],"published-print":{"date-parts":[[2025,8]]},"DOI":"10.1016\/j.artd.2025.101778","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T18:39:07Z","timestamp":1754591947000},"page":"101778","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["Femoral Component Loosening is the Predominant Mode of Early Failure in Contemporary Cementless Total Knee Arthroplasty"],"prefix":"10.1016","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1029-7015","authenticated-orcid":false,"given":"Stephen W.","family":"Chenard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary E.","family":"Mulvey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander P.","family":"Mika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney E.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher E.","family":"Pelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Gregory G.","family":"Polkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Ryan","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.artd.2025.101778_bib1","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.arth.2021.11.031","article-title":"Redefining indications for modern cementless total knee arthroplasty: clinical outcomes and survivorship in patients >75 years old","volume":"37","author":"Goh","year":"2022","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib2","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1055\/s-0039-1678687","article-title":"Cementless versus cemented fixation in total knee arthroplasty","volume":"32","author":"Papas","year":"2019","journal-title":"J Knee Surg"},{"key":"10.1016\/j.artd.2025.101778_bib3","doi-asserted-by":"crossref","first-page":"22","DOI":"10.3390\/jcm11226608","article-title":"The evolution, current indications and outcomes of cementless total knee arthroplasty","volume":"11","author":"Schwabe","year":"2022","journal-title":"J Clin Med"},{"key":"10.1016\/j.artd.2025.101778_bib4","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1302\/2058-5241.5.200030","article-title":"Cemented vs. Cementless fixation in primary total knee arthroplasty: a systematic review and meta-analysis","volume":"5","author":"Prasad","year":"2020","journal-title":"EFORT Open Rev"},{"key":"10.1016\/j.artd.2025.101778_bib5","doi-asserted-by":"crossref","first-page":"355","DOI":"10.3928\/01477447-20190906-04","article-title":"Early results of a modern uncemented total knee arthroplasty system","volume":"42","author":"Manoli","year":"2019","journal-title":"Orthopedics"},{"key":"10.1016\/j.artd.2025.101778_bib6","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1302\/2633-1462.21.BJO-2020-0172.R1","article-title":"Cementless knee arthroplasty: a review of recent performance","volume":"2","author":"Asokan","year":"2021","journal-title":"Bone Jt Open"},{"key":"10.1016\/j.artd.2025.101778_bib7","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/00003086-200111000-00024","article-title":"Problems with cementless total knee arthroplasty at 11 years followup","volume":"392","author":"Berger","year":"2001","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.artd.2025.101778_bib8","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1302\/0301-620X.74B2.1544961","article-title":"The press-fit kinemax knee arthroplasty. High failure rate of non-cemented implants","volume":"74","author":"Nafei","year":"1992","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.artd.2025.101778_bib9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/BLO.0b013e31814d4d19","article-title":"Sterilization and wear-related failure in first- and second-generation press-fit condylar total knee arthroplasty","volume":"464","author":"Griffin","year":"2007","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.artd.2025.101778_bib10","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1302\/0301-620X.86B2.14341","article-title":"Hydroxyapatite-coated, cementless total knee replacement in patients aged 75 years and over","volume":"86","author":"Dixon","year":"2004","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.artd.2025.101778_bib11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0232378","article-title":"Hydroxyapatite-coated implants provide better fixation in total knee arthroplasty. A meta-analysis of randomized controlled trials","volume":"15","author":"Horvath","year":"2020","journal-title":"PLoS One"},{"issue":"6 Supple A","key":"10.1016\/j.artd.2025.101778_bib12","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1302\/0301-620X.103B6.BJJ-2020-2096.R1","article-title":"Excellent mid-term follow-up for a new 3d-printed cementless total knee arthroplasty","volume":"103-B","author":"Restrepo","year":"2021","journal-title":"Bone Joint J"},{"key":"10.1016\/j.artd.2025.101778_bib13","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/j.arth.2014.02.016","article-title":"Micromotion of cementless tibial baseplates: keels with adjuvant pegs offer more stability than pegs alone","volume":"29","author":"Bhimji","year":"2014","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib14","doi-asserted-by":"crossref","first-page":"3100","DOI":"10.1007\/s00167-022-06860-4","article-title":"Component migration, bone mineral density changes, and bone turnover markers in cementless and cemented total knee arthroplasty: a prospective randomized rsa study in 53 patients with 2-year follow-up","volume":"30","author":"Linde","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.artd.2025.101778_bib15","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1302\/0301-620X.103B1.BJJ-2020-0788.R1","article-title":"What is the role of cemented fixation in total knee arthroplasty? The two-year results of a randomized rsa controlled trial","volume":"103-B","author":"van Ooij","year":"2021","journal-title":"Bone Joint J"},{"key":"10.1016\/j.artd.2025.101778_bib16","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1302\/0301-620X.102B8.BJJ-2020-0054.R1","article-title":"Migration of a novel 3d-printed cementless versus a cemented total knee arthroplasty: two-year results of a randomized controlled trial using radiostereometric analysis","volume":"102-B","author":"Hasan","year":"2020","journal-title":"Bone Joint J"},{"key":"10.1016\/j.artd.2025.101778_bib17","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1302\/0301-620X.99B11.BJJ-2016-1347.R3","article-title":"Fixation and clinical outcome of uncemented peri-apatite-coated versus cemented total knee arthroplasty : five-year follow-up of a randomised controlled trial using radiostereometric analysis (rsa)","volume":"99-B","author":"van Hamersveld","year":"2017","journal-title":"Bone Joint J"},{"key":"10.1016\/j.artd.2025.101778_bib18","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.2106\/JBJS.18.01162","article-title":"Cemented versus cementless total knee arthroplasty of the same modern design: a prospective, randomized trial","volume":"101","author":"Nam","year":"2019","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.artd.2025.101778_bib19","doi-asserted-by":"crossref","first-page":"S183","DOI":"10.1016\/j.arth.2019.02.024","article-title":"To cement or not? Five-year results of a prospective, randomized study comparing cemented vs cementless total knee arthroplasty","volume":"34","author":"Fricka","year":"2019","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib20","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s00264-013-2243-4","article-title":"Cementless and cemented total knee arthroplasty in patients younger than fifty five years. Which is better?","volume":"38","author":"Kim","year":"2014","journal-title":"Int Orthop"},{"key":"10.1016\/j.artd.2025.101778_bib21","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1016\/j.arth.2014.03.006","article-title":"Cemented versus cementless fixation of a tibial component in lcs mobile-bearing total knee arthroplasty performed by a single surgeon","volume":"29","author":"Choy","year":"2014","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib22","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.arth.2016.07.027","article-title":"Medial tibial stress shielding: a limitation of cobalt chromium tibial baseplates","volume":"32","author":"Martin","year":"2017","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib23","doi-asserted-by":"crossref","DOI":"10.1016\/j.medengphy.2023.104072","article-title":"The sensitivity of the stiffness and thickness of a titanium inlay in a cementless peek femoral component to the micromotions and bone strain energy density","volume":"122","author":"Post","year":"2023","journal-title":"Med Eng Phys"},{"key":"10.1016\/j.artd.2025.101778_bib24","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.arth.2016.06.007","article-title":"Tibial tray thickness significantly increases medial tibial bone resorption in cobalt-chromium total knee arthroplasty implants","volume":"32","author":"Martin","year":"2017","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib25","doi-asserted-by":"crossref","first-page":"5857","DOI":"10.1007\/s00402-023-04837-7","article-title":"Favorable outcomes of posterior cruciate-stabilized inserts over ultracongruent inserts in total knee arthroplasty","volume":"143","author":"Obana","year":"2023","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.artd.2025.101778_bib26","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.arth.2019.08.032","article-title":"The natural history of radiolucencies following uncemented total knee arthroplasty at 9 years","volume":"35","author":"Costales","year":"2020","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib27","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.artd.2022.02.011","article-title":"A short-term multicenter analysis of radiolucent lines in a single uncemented rotating platform implant for total knee arthroplasty","volume":"15","author":"Desmarais","year":"2022","journal-title":"Arthroplast Today"},{"key":"10.1016\/j.artd.2025.101778_bib28","doi-asserted-by":"crossref","first-page":"101082","DOI":"10.1016\/j.artd.2022.101082","article-title":"Effect of tobacco use on radiolucent lines in modern Cementless total knee arthroplasty tibial components","volume":"19","author":"Patel","year":"2023","journal-title":"Arthroplast Today"},{"key":"10.1016\/j.artd.2025.101778_bib29","doi-asserted-by":"crossref","first-page":"3131","DOI":"10.1007\/s00167-022-07047-7","article-title":"Modern cementless posterior stabilized mobile-bearing total knee arthroplasty shows comparable clinical and radiographical results to its cemented predecessor at 1-year follow-up","volume":"30","author":"Mikashima","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.artd.2025.101778_bib30","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1177\/0300060518757927","article-title":"Radiolucent lines are decreased at 3 years following total knee arthroplasty using trabecular metal tibial components","volume":"46","author":"Mutsuzaki","year":"2018","journal-title":"J Int Med Res"},{"key":"10.1016\/j.artd.2025.101778_bib31","doi-asserted-by":"crossref","first-page":"2311","DOI":"10.1016\/j.arth.2015.05.049","article-title":"Development of a modern knee society radiographic evaluation system and methodology for total knee arthroplasty","volume":"30","author":"Meneghini","year":"2015","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib32","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1007\/s11999-016-4719-1","article-title":"Validation of the koos, jr: a short-form knee arthroplasty outcomes survey","volume":"474","author":"Lyman","year":"2016","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.artd.2025.101778_bib33","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1016\/j.arth.2013.07.024","article-title":"Why are total knee arthroplasties failing today--has anything changed after 10 years?","volume":"29","author":"Sharkey","year":"2014","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib34","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1016\/j.arth.2017.02.062","article-title":"Uncemented metal-backed tantalum patellar components in total knee arthroplasty have a high fracture rate at midterm follow-up","volume":"32","author":"Chan","year":"2017","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib35","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1055\/s-0043-56997","article-title":"Results of a highly porous metal-backed cementless patella implant: a minimum 5-year follow-up","volume":"37","author":"Baker","year":"2024","journal-title":"J Knee Surg"},{"key":"10.1016\/j.artd.2025.101778_bib36","doi-asserted-by":"crossref","first-page":"6S:S145","DOI":"10.1016\/j.arth.2023.02.009","article-title":"Cementless total knee arthroplasty over the past decade: excellent survivorship in contemporary designs","volume":"38","author":"Helvie","year":"2023","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib37","doi-asserted-by":"crossref","first-page":"20902","DOI":"10.1038\/s41598-024-71806-4","article-title":"Clinical outcomes and radiolucent line analysis in cementless mobile-bearing total knee arthroplasty: a prospective multicentre study in Japan","volume":"14","author":"Minoda","year":"2024","journal-title":"Sci Rep"},{"key":"10.1016\/j.artd.2025.101778_bib38","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/j.arth.2008.06.035","article-title":"Prospective, randomized comparison of cobalt-chrome and titanium trilock femoral stems","volume":"24","author":"Healy","year":"2009","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib39","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.arth.2021.11.012","article-title":"Trends in polyethylene design and manufacturing characteristics for total knee arthroplasty: an analysis from the american joint replacement registry","volume":"37","author":"Kendall","year":"2022","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib40","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1016\/j.arth.2020.02.004","article-title":"In vivo knee kinematics for a cruciate sacrificing total knee arthroplasty having both a symmetrical femoral and tibial component","volume":"35","author":"Khasian","year":"2020","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.artd.2025.101778_bib41","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.arth.2004.02.030","article-title":"Progression of radiolucent lines in cementless twin-bearing low-contact-stress knee prostheses: a retrospective study","volume":"19","author":"Aebli","year":"2004","journal-title":"J Arthroplasty"}],"container-title":["Arthroplasty Today"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2352344125001657?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2352344125001657?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T05:48:14Z","timestamp":1760075294000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2352344125001657"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":41,"alternative-id":["S2352344125001657"],"URL":"https:\/\/doi.org\/10.1016\/j.artd.2025.101778","relation":{},"ISSN":["2352-3441"],"issn-type":[{"value":"2352-3441","type":"print"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Femoral Component Loosening is the Predominant Mode of Early Failure in Contemporary Cementless Total Knee Arthroplasty","name":"articletitle","label":"Article Title"},{"value":"Arthroplasty Today","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.artd.2025.101778","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons\u00e9","name":"copyright","label":"Copyright"}],"article-number":"101778"}}