Limitations
TKA
This study has several limitations. Firstly, this study presents a randomized controlled trial evaluating the cement penetration of the tibial component in TKA. However, the small sample size limits the analysis of the results. Secondly, only the cement penetration of the tibial component was analyzed, the femoral component cement penetration could not be assessed accurately on an anteroposterior radiograph, which is a limitation of the study. Further research is needed to investigate also the femoral component, with Roentgen Stereogrammetric Analysis potentially representing an effective tool to this aim. Thirdly, all surgeons were intraoperatively not blinded to the performed intervention. To reduce bias, the bone surface preparation, cement application, pressurization, and implantation of the components were standardized in both groups. Lastly, it should be noted that this study only evaluates cement penetration and cannot be extrapolated to TKA implant survivorship or longevity, further investigations evaluating the correlation between cement penetration and long-term outcomes of TKA implants are required.