Femoral Component Loosening is the Predominant Mode of Early Failure in Contemporary Cementless Total Knee Arthroplasty

Femoral radiolucent lines were common in this study. Although femoral component loosening was the most frequent cause of revision, these lines did not generally necessitate revision or correlate with poorer patient-reported outcomes. Thus, radiolucent lines do not inherently indicate clinical failure or reduced patient satisfaction. There was only one case of tibial component loosening, suggesting that the current design features achieve robust fixation, while the prevalence of femoral radiolucent lines and failures suggests that further enhancements to the femoral implant may be necessary.