Screw and cement fixation of large defects in total knee arthroplasty

Fifty-seven total knee arthroplasties with defects in the tibial plateaus filled with screw and cement were followed longer than 3 years. At 3 years, 15 of them had radiolucency between the cement-bone interface that was unchanged from the 2-month postoperative radiograph. No radiolucency was noted about the stem bone-cement interface or between the screw and the bone. Ten of the 27 knees followed longer than 4 years had similar findings. There were no loose tibial components in any of the 57 total knee arthroplasties. It is possible to fill defects with screws rather than cut off more bone or use expensive custom prostheses.