Summary

Cementless TKR has excellent result in young patients

Abstract

Introduction

Cementless Total Knee Replacement (TKR) was introduced to improve the longevity of implant especially in younger patient , but has yet to be widely adopted because of reports of higher earlier failures rates in some series and lack of long-term follow up studies in the literature. The purpose of this study isto evaluate the clinical and radiographic results of all cementless total knee replacement with a minimum of eight years follow up.

MATERIAL & METHOD:

From 2008 to 2010, 317 Primary Total knee arthroplasties have been performed, 65 case as single TKR and 252 as bilateral TKR (191patient, 80% females and 20% males) . The implants that were used are cementless titanium based femoral component, and cementless tantalum mono block tibial component .
Surgery was performed mainly on younger patients (average age was 48 yrs old ranging from 26 yrs old to 62 yrs old). All surgeries were performed by one surgeon, All patients were followed up clinically and radiologically for a minimum of 8 years (range from 8 to 10 years). The underlying diagnosis was primary knee arthritis in 97% of cases, rheumatoid arthritis in 3% of cases.

Results

Only 8 cases required revision - 3 cases for sepsis and 5 cases for aspetic loosening of the femoral component, There were no cases with tibial component loosening , radiologically , nor subsidence, at the latest follow-up , for an end point for survivorship was a 100% for the tibia monoblock design .Osteolysis was seen in another 16 cases around the femoral component, and in 15 case around tibial component, however in all these cases stability of the components was not affected. Knee society scores improved from 51 pre-operatively to 94 post operatively.

Discussion And Conclusion

Cementless TKR has excellent result as compared to the cemented with a good survivorship at 10 years. The tantalum tibial mono-block component shows an excellent survivorship. The femoral component also presents reasonably good result. we strongly recommend using the cementless implant in young patients. We believe that cementless tibial is totally safe at this point as well as the femoral cementless. we expect some improvement in the outcome with the femoral component when using the tantalum.