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Thursday, March 1, 2001

Screw fixation enhances cementless tibial component

A review of 124 consecutive cementless total knee arthroplasties (Miller-Galante) in 99 patients (age 62 years) with osteoarthritis found survival of the cementless tibial component was 98.3 percent at 12 years postoperatively.

"These results indicate that osseointegration of a cementless tibial component is enhanced with screw fixation, and although there is a worrisome incidence of tibial osteolysis the implant has a high level of survival," say investigators in poster exhibit 444.

Knee function was evaluated using a quantitative scoring system and radiological assessments by the Knee Society criteria. Four patients (five knees) were lost to follow-up and three patients died (three knees) with their knee in place. The mean preoperative knee score was 32 (0-47) which improved to 91 (52-100). The joint line changed 2.4 + 4.8 mm. The mean knee alignment was 5.5 degrees valgus. Only one tibial component demonstrated a progressive complete radiolucent line of 3 mm (subsequently revised) while 34 tibial trays had an incomplete < 2 mm line seen in Zone 1.

Twenty-four tibial trays (21 percent) demonstrated definite osteolysis. None required revision. Although 12 metal-backed (MB) patellar components and eight femoral implants were revised, only one tibial tray has been revised. Ten of the failed MB patellae fell outside of an optimal radiographic alignment criteria.

Victor M. Goldberg, MD, and Matthew J. Kraay, MD, both of Cleveland, Ohio, are the investigators.

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2001 Academy News March 1 Index B

Last modified 20/February/2001 by IS