Abstract
Aims: Cementless fixation in TKA remains controversial because of less predictable osseointegration and difficulty interpreting fixation interfaces.
Methods: This study evaluated 567 consecutive primary LCS mobile-bearing TKA with in-depth RLZ analysis of all cases by one author (T.K.). Mean follow-up was 5.7 years (2.0–14.9), mean age 69 years (70% females). Diagnosis included 8.3% rheumatoids. The same poro-coated femoral and patella components were utilized. Tibial components included a 3-fin (ACL/PCL-retaining) or tapered-cone design (PCL-retaining/substituting). Bone treatment included generous use of autograft: cortico-cancellous struts for slope-off deformities and soft bone, morselized impaction for central zones, slurry to achieve interference fit.
Results: Good/excellent results were 94.7%. Minimal femoral/patella lucencies; Tibial tapered cone (n = 523) had one (0.2%) failure. Lucencies of 1–2 mm (usually isolated) were noted in 2% medial, lateral, posterior and 4% anterior/central zones, all of which remained stable; 3) Tibial 3-fin tibial design (n = 44) had 3 failures (6.8%) with RLZ > 2mm in multiple zones.
Conclusion: Cementless fixation with LCS porocoat prosthesis was successful in all femoral/patellar and 99% of the tibial-cone design. The 3-fin design had multiple RLZ and a higher failure rate (not recommended).
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
