Total knee replacements (TKR) both cemented and uncemented were developed almost simultaneously in the 1980’s. Cemented TKR found favor among the surgeons due to its technical ease and early failure of uncemented TKR due to poor design. In the past two decades; however, interest has been generated in uncemented TKR both because of design improvements which, in turn, has led to better results, especially in young active, obese, and geriatric but active patients where cemented TKR’s have been found to have increased failure rates. Active research is ongoing to refine the designs of uncemented TKR and future holds promise for this re-emerging technique and implant. This review helps to summarize the reasons for increasing interest in uncemented TKR, the newer designs and their results and the future developments expected.

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