Use of Screws and Cement in Primary TKA with Up to 20 Years Follow-Up

Abstract The purpose of this study was to investigate screws and cement for large tibial bone defects during primary TKA. Of 14,686 consecutive primary TKAs performed between December 1988 and February 2010, 256 received screws and cement for tibial defects. Cox regression was used for the analysis....

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Bibliographic Details
Published in:The Journal of arthroplasty 2014-06, Vol.29 (6), p.1207-1210
Main Authors: Berend, Michael E., MD, Ritter, Merrill A., MD, Keating, E. Michael, MD, Jackson, Michael D, Davis, Kenneth E., MS
Format: Article
Language:English
Subjects:
Arthritis - surgery
Arthroplasty, Replacement, Knee
Bone Cements
Bone Resorption - surgery
Bone Screws
Follow-Up Studies
Humans
Knee Joint - surgery
Orthopedics
Radiography
Tibia - diagnostic imaging
Tibia - surgery
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Summary:Abstract The purpose of this study was to investigate screws and cement for large tibial bone defects during primary TKA. Of 14,686 consecutive primary TKAs performed between December 1988 and February 2010, 256 received screws and cement for tibial defects. Cox regression was used for the analysis. 20-year survival probability was 0.9897 (screws) and 0.9339 (no screws) ( P = .4225 log-rank). Tibial bone condition was significantly worse in knees receiving screws ( P < .0001) with 73.0% having defects in the screws group and 3.4% ( P < .0001) for non-screws. Radiolucency appeared in 13.7% (screws) and 6.4% (no screws) postoperatively. Screws were $137 each, wedges $910 to $2240. Knees with tibial defects and screws performed similarly if not better than knees without defects at substantially lower cost than alternatives.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2013.12.023