Early Results of a Modular Cementless Tibial Component for Total Knee Arthroplasty
Cementless components in TKA have been used for almost 3 decades, despite mixed success rates. However, biologic fixation remains attractive, especially for younger patients, because of the potential of unlimited durability. This paper is the first to report results on a modular tibial base plate using trabecular metal as a fixation surface. Twenty-four primary TKAs were evaluated clinical and radiographically at mean 1.9 year followup. Excellent clinical results were obtained. There was no significant subsidence or change in orientation of any component. One component was probably loose radiographically but was insufficiently symptomatic to warrant revision. Five components showed nonprogressive radiolucent lines. One reoperation was performed for stiffness, at which time the components were well fixed. Thus, it would appear that excellent bony fixation can be achieved with a modular cementless tibial component with excellent short-term clinical results.
Meneghini, R M, and Arlen Hanssen. “Cementless fixation in total knee arthroplasty: past, present, and future.” The journal of knee surgery 21.4 (2008):307-314.
Berger, R A, et al. “Problems with cementless total knee arthroplasty at 11 years followup.” Clinical orthopaedics and related research .392 (2001):196-207.
Sanchis Alfonso, V, and JAlcacer García. “Extensive osteolytic cystlike area associated with polyethylene wear debris adjacent to an aseptic, stable, uncemented unicompartmental knee prosthesis: case report.” Knee surgery, sports traumatology, arthroscopy 9.3 (2001):173-177.
Moran CG, Pinder IM, Lees TA, et al: Survivorship analysis of the uncemented porous-coated anatomic knee replacement. J Bone Joint Surg 73A:848–857, 1991.
Carlsson, Ake, et al. “Cemented tibial component fixation performs better than cementless fixation: a randomized radiostereometric study comparing porous-coated, hydroxyapatite-coated and cemented tibial components over 5 years.” Acta orthopaedica 76.3 (2005):362-369.
Goldberg, Victor, and Matthew Kraay. “The outcome of the cementless tibial component: a minimum 14-year clinical evaluation.” Clinical orthopaedics and related research .428 (2004): 214-220.
Kim, Young-Hoo, et al. “Cementless and cemented total knee arthroplasty in patients younger than fifty five years. Which is better?.” International orthopaedics (2014).
Gejo, Ryuichi, ShawAkizuki, and TsutomuTakizawa. “Fixation of the NexGen HA-TCP-coated cementless, screwless total knee arthroplasty: comparison with conventional cementless total knee arthroplasty of the same type.” The Journal of arthroplasty 17.4 (2002):449-456.
Pijls, Bart, et al. “The beneficial effect of hydroxyapatite lasts: a randomized radiostereometric trial comparing hydroxyapatite-coated, uncoated, and cemented tibial components for up to 16 years.” Acta orthopaedica 83.2 (2012):135-141.
Dunbar, M J, et al. “Fixation of a trabecular metal knee arthroplasty component. A prospective randomized study.” Journal of Bone and Joint Surgery; American volume 91.7 (2009):1578-1586.
Schroder HM, Berthelsen A, Hassani G, Hansen EB, Solgaard S. Cementless porous-coated total knee arthroplasty. J Arthroplasty. 2001;16(5):559–67
How to Cite
Copyright (c) 2014 Raj Sinha, MD, PhD, Cristian Balcescu
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright and License Agreement:
Authors who publish with the Reconstructive Review agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work. Reconstructive Review follows the Creative Commons Attribution-NonCommercial CC BY-NC. This license allows anyone to download works, build upon the material, and share them with others for non-commercial purposes as long as they credit the senior author, Reconstructive Review, and the Joint Implant Surgery & Research Foundation (JISRF). An example credit would be: "Courtesy of (senior author's name), Reconstructive Review, JISRF, Chagrin Falls, Ohio". While works can be downloaded and shared they cannot be used commercially.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.