Abstract
INTRODUCTION
Total knee arthroplasty (TKA) is typically performed using cement to secure the prosthesis to bone. There are complications associated with cementing that include intra-operative hypotension, third-body abrasive wear, and loosening at the cement interfaces. A cementless prosthesis using a novel keeled trabecular metal tibial baseplate was developed to eliminate the need for cementing the tibial component in TKA.
METHODS
A retrospective chart review was performed on patients who underwent TKA using cementless tibial and femoral components between August, 2013 and January, 2014. Patients with minimum two-year follow-up including radiographs were included in the analysis. Patient demographics as well as preoperative and postoperative range of motion (ROM) and function were measured using the Knee Society Scoring system (KSS). Post-operative radiographs were assessed for signs of osteolysis, loosening, or subsidence. Paired T-tests were used to identify differences in preoperative and postoperative ROM and KSS.
RESULTS
Thirty-three patients underwent 48 TKAs in the study period. Of those, 20 patients (29 knees) completed two-year follow-up. The mean patient age was 69.0 ±8.4 years and mean BMI was 29.9 ±4.3. The average time of follow-up was 24.6 months (range 24–29). Preoperative ROM was on average 4.3–117.3°±6.7 and the preoperative KSS knee scores and functional scores were 43.8 ±8.6 and 49.8 ±12.6, respectively. Postoperatively, there were statistically significant improvements in ROM (0–130.7°±7.3), and postoperative KSS knee (98.4 ±3.2) and functional scores (99.3 ±2.6), at two years, respectively. None of the radiographs demonstrated evidence of osteolysis, loosening, migration, or subsidence.
DISCUSSION and CONCLUSION
The two-year results of TKA utilizing a cementless tibial baseplate demonstrate excellent results in terms of knee ROM and function. The radiographic evidence of osteointegration without evidence of loosening, subsidence, or migration of the tibial components is promising. Further follow up is necessary to ensure that these implants will provide a satisfactory long-term alternative to cement fixation.
