Objective To summarize the technological evolution, clinical advantages, and cutting-edge development trends of cementless prostheses for total knee arthroplasty (TKA), so as to provide a reference for the clinical treatment of end-stage knee osteoarthritis and the research and development of prosthesis technology. MethodsRelevant researches and technical achievements over more than 40 years in the field of cementless prostheses for TKA were systematically reviewed. This study focused on iterative upgrades and carried out comprehensive analysis combined with clinical application data and revision-related studies. Results Benefiting from the advantage of cementless fixation, cementless prostheses can effectively avoid bone-cement-related complications. Prosthesis coating materials have undergone multi-generation iterations, and friction-interface materials present favourable prospects for bionic-oriented application. Robot-assisted surgical systems can markedly improve the primary-fixation reliability of biological prostheses.Conclusion Materials and surgical-assisted techniques for cementless prostheses keep being innovated and their clinical outcomes are continuously optimized. Artificial-intelligence-aided surgical planning and patient-specific customized prostheses will become the core research directions in this field.
