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Noncemented tibial components: does a stem help?

H U Cameron1

  • 1Departments of Surgery, Pathology, and Engineering, University of Toronto, Canada.

Contemporary Orthopaedics
|February 8, 1992
PubMed
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Adding a stem to the tibial component in noncemented total knee replacement significantly reduces tibial sinkage. This stem enhances implant stability and patient preference, improving outcomes for knee replacement surgery.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Total knee replacement (TKR) is a common procedure for end-stage knee osteoarthritis.
  • Noncemented tibial components are widely used but can be associated with subsidence or sinkage.
  • Preventing tibial sinkage is crucial for long-term implant survival and function.

Purpose of the Study:

  • To evaluate the efficacy of a stemmed tibial component in reducing sinkage during noncemented total knee replacement.
  • To compare the incidence of tibial sinkage between stemmed and nonstemmed tibial components.
  • To assess patient preference and clinical outcomes associated with stemmed versus nonstemmed components.

Main Methods:

  • A prospective, nonrandomized study comparing stemmed (n=125) and nonstemmed (n=307) tibial components in TKR.

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  • Follow-up duration ranged from two to six years.
  • A subset of 34 patients underwent a direct comparison with one stemmed and one nonstemmed component.

    • Main Results:

    • Sinkage occurred in 0.8% of stemmed components versus 3.5% of nonstemmed components.
    • Two cases (0.8%) with nonstemmed components required revision due to sinkage.
    • Clinical outcomes were similar between groups, but 50% of patients preferred the stemmed component in direct comparison.

    Conclusions:

    • The addition of a stem to the tibial component effectively prevents tibial sinkage in noncemented TKR.
    • Stemmed components offer improved mechanical stability and may enhance patient satisfaction.
    • This modification represents a valuable advancement in TKR implant design for improved longevity.