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Wednesday, February 28, 2001

No differences found in stability between screw, screwless fixation in cementless TKA

A review of 120 consecutive cementless total knee arthroplasty patients found no difference in osteolysis or stability exists between screw and screwless fixation of an FDA-approved cementless tibial component with four smooth pegs and a central cruciate stem.

The study in scientific exhibit 25 included one group of 60 consecutive cementless total knee arthroplasties without tibial screw fixation and another group of 60 consecutive cementless total knee arthroplasties with screw fixation using two 6.5mm cancellous screws. All procedures were performed by Matthew Friederichs, MD, department of orthopaedics, University of Utah, Salt Lake City, Utah. The radiographs were carefully examined for polyethylene wear, osteolysis under the baseplate and surrounding the screws and the absence or preservation of radiolucent lines. Clinical evaluation was done using the HSS Knee Score for both groups. Average age of the patients was 60 years (range: 33 - 98).

Follow-up averaged 40 months (34 - 48). Average knee score was 94. No difference existed in metaphyseal osteolysis or osteolysis surrounding the screws between the two study groups. No patient in either group failed for aseptic loosening.

The researchers say their study demonstrates that cementless tibial fixation is stable with or without screws with no difference in fixation or osteolysis if peripheral pegs and a central keel is used. Therefore, they say screw fixation should be considered optional.

In addition to Dr. Friederichs, the researchers included Aaron A. Hoffman, MD; Michael E. Feign, DO; and Marcelo P. Camargo, MD, all of the department of orthopaedics, University of Utah, Salt Lake City, Utah.

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2001 Academy News February 28 Index B

Last modified 20/February/2001 by IS