Cementless Highly Porous Titanium Tibial Base Plate in Total Knee Arthroplasty – Midterm Outcomes.

Abstract

Introduction & Aims
 TKA in more active and young patients has prompted the interest in more durable and biological methods of Osteo-integration with cementless components. With the emergence of improved biomaterials like porous titanium and the success, search for a cementless TKA with long-term durability and survivorship may have ended. This is a retrospective study of 492 consecutive TKAs using Cementless tibial fixation, reporting on the early 4 years clinical and radiological outcomes.
 Method
 We studied 492 TKAs performed consecutively by a single surgeon between 1stJan. 2010 and 31stDec. 2015 using a cementless, fixed bearing tibial tray (porous–Regenerex, Vanguard, Zimmer-Biomet) and a cementless femoral component (Vanguard) with no exclusion criteria. Clinical and radiological follow-up was done on these patients and in addition a comprehensive joint registry review was performed on the whole cohort (Level II evidence).
 Results
 The average Knee Society Score at final follow-up was 89.33, average pre-op being 42.06. Average post-op WOMAC score was 43.45 and average pre-op was 77.78. On radiological examination, no patients had osteolysis around tibial base plate. In our series 9 patients were revised, out of which only 4 patients had the tibial tray and femoral component revised and 5 patients had patella resurfacing or liner exchange. Overall survivorship of the cementless tibial component is excellent with a survivorship of 99.4% at 5.9 years based on a comprehensive AOANJRR data.
 Conclusions
 Cementless tibial fixation using a porous titanium construct can provide stable bone ingrowth fixation on the tibial side with excellent and predictable early 4 to 5 year clinical and radiological outcomes.

Development of patient-specific 3D printed implants for total knee arthroplasty

“…The osseous defect was filled with a tibial reaming autologous transplant. Fractured tibial components in both cemented and uncemented models, osteolysis, and long-term polyethylene wear were recognised as the predominant reasons for implant failure [17]. After the failure of cementless models, screw-based fixation was replaced by anchored tibial models as it eliminated screw holes and provided a larger surface area for implant fixation.…”