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Cementless TKA with a highly porous titanium tibia.


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.