Comparison of screw and screwless fixation in cementless total knee arthroplasty

This study compared two groups of consecutive patients undergoing total knee arthroplasty (TKA) with an identical cementless tibial baseplate supplementally fixated with and without screws. In 58 TKAs, two 6.5-mm cancellous screws were used for fixation, and in 58 TKAs, screwless fixation was used. Clinical evaluation was performed using the Hospital for Special Surgery knee score, and fluoroscopically guided radiographs were evaluated for radiolucencies. In the screw fixation group, average follow-up was 82+/-6 months (range, 59-89 months) and average patient age at surgery was 63 years. For the screwless fixation group, average follow-up was 67+/-5 months (range, 48-76 months) and average patient age at surgery was 62 years. Average knee score was 97 for the screw fixation group and 98 for the screwless fixation group. This study demonstrated stability in cementless TKA both with and without screw fixation in the mid-term using the Natural-Knee II tibial component.