Abstract
Uncemented Total Knee Arthroplasty (TKA) is an alternative to cemented TKA and hybrid fixation. We present incidence of loosening of uncemented porus coated tibial trays (two to five years with a mean of 3.8 years) in our retrospective clinical and radiological follow up of 53 uncemented TKA in 40 patients.
Between 2001 and 2007, 53 uncemented primary TKA were performed by two senior surgeons in 53 knees for 40 patients. This was for diagnosis of Osteoarthritis. Five patients underwent patellar resurfacing. Patients were evaluated at the six week mark, three months, one year and then yearly using Knee Society knee score. In addition, radiograph analysis was done to all patients during each visit and evaluated using Knee Society roentgenographic evaluation and scoring system. The follow-ups have been done by independent surgeons.
End point of failure is defined as revision. There were 14 revisions (12 for aseptic loosening, none for infection and one for component malposition, one for instability) among 53 knees. We found that there is significant increase in rate of tibial component loosening (26%), which is very high compared to rate of loosening with other series. There is radiographic evidence of loosening in four femoral prosthesis but one required revision. Intraoperatively we noticed that there is very poor osseointegration into tibial components. All of them have been revised with cemented tibial component.
With our experience we conclude that uncemented porus coated Tibial trays have higher rates of failures because of poor osseointegration. And we recommend that all tibial trays need to be cemented.
