23rd – 26th AUGUST, 2023
Presenting Author - Smit Shah
Introduction & aims – TKA in more active and young patients has prompted the interest in more
durable and biological methods of osseointegration with cementless components. With the
emergence of improved biomaterials like porous titanium and the success of certain cementless
designs, the search for a cementless TKA with long-term durability and survivorship may have
ended. This is a retrospective study of 519 consecutive TKAs using cementless tibial fixation,
reporting midterm clinical and radiological outcomes. Method- We reviewed 519 TKAs
performed consecutively by a single surgeon between 2009 and 2015 using a cementless, fixed
bearing tibial tray (porous titanium construct–Regenerex, Vanguard, Zimmer-Biomet) and a
cementless femoral component (Vanguard). Clinical and radiological follow-up was done on
these patients. Results - The average knee score at final follow-up using Knee Society Score was
92.88, average pre-op being 42.47. Average post-op WOMAC score was 37.77 and average preop
was 77.55. On radiological examination of a subgroup of patients presenting for follow up, no
patients had osteolysis around the tibial base plate although a small number of minor
radiolucencies were seen. Nine of the patients were revised, of which only 4 had the tibial and
femoral components revised whilst 5 had a patella resurfacing +/- liner exchange. The total
cumulative revision rate at 5.9years is 2.4% for our series, compared with 4.5% for other
cementless TKA and 3.4% for cemented TKA as per ANJRR data review. Conclusions– Based on
our results, we conclude that Cementless tibial fixation using a porous titanium construct
(ZimmerBiomet, Regenerex) can provide stable bone ingrowth fixation on the tibial side with
excellent and predictable midterm clinical and radiological outcomes.
Asia Pacific Arthroplasty Society Incorporated