Wyatt RWB, Chang RN, Royse KE, et al. - This study was undertaken to investigate the revision risk following total knee arthroplasty (TKA) with high viscosity cement (HVC) compared to medium viscosity cement (MVC) in a large cohort. A cohort study was performed using data from the United States integrated healthcare system’s total joint replacement registry. Researchers distinguished patients who had undergone fully cemented primary TKA for osteoarthritis between 2001 and 2018. The risk for any revision during follow-up and risk for revision from aseptic loosening specifically was assessed by using Propensity score-weighted Cox proportional hazards regression. A total of 76,052 TKA, 41.1% using MVC were included in this cohort. There was no difference in revision for aseptic loosening specifically, while they observed a lower risk for any revision with the use of Simplex MVC in comparison with Palacos HVC. Given the widespread use of HVC, a future trial is needed to evaluate other HVC and potential mechanisms for failure outside of loosening.