Long-term comparative study evaluating the screw-cement construct for tibial defects in total knee arthroplasty: our...

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Reconstructive Surgery

Background:

• Total knee arthroplasty (TKA) is standard for end-stage knee osteoarthritis.
• Severe deformities and tibial bone loss pose challenges in TKA.
• The cement screw construct offers a cost-effective solution for tibial defects.

Purpose of the Study:

• To evaluate the clinical, functional, and radiological outcomes of the screw-cement construct for tibial defects in TKA.
• To assess the long-term success rate of this technique in patients with significant tibial bone loss.

Main Methods:

• Retrospective study of 65 patients (104 knees) undergoing TKA.
• Comparison between conventional TKA (Group A) and TKA with screw-cement construct (Group B).
• Data collection included demographics, clinical assessments, and radiological evaluation with a minimum eight-year follow-up.

Main Results:

• Both groups showed significant postoperative improvements in knee morphology and function.
• Group B had increased radiolucency around the tibial tray, but no progressive complications.
• Implant survival rates and complication incidence (aseptic loosening, infection) were similar between groups.

Conclusions:

• The screw-cement construct is effective for managing uncontained tibial defects in TKA.
• This technique demonstrates efficacy and cost-effectiveness.
• It is a potential standard approach for tibial defects up to 20mm.