Total knee replacement-cementless tibial fixation with screws: 10-year results

Acta Orthop Traumatol Turc. 2017 Dec;51(6):433-436. doi: 10.1016/j.aott.2017.10.008. Epub 2017 Nov 1.


Background: The aim of this study was to evaluate the long term clinical and radiological results of cementless total knee replacement.

Methods: A total of 51 knees of 49 patients (33 female and 16 male; mean age: 61.6 years (range, 29-66 years)) who underwent TKR surgery with a posterior stabilized hydroxyapatite coated knee implant were included in this study. All of the tibial components were fixed with screws. The HSS scores were examined preoperatively and at the final follow-up. Radiological assessment was performed with Knee Society evaluating and scoring system. Kaplan-Meier survival analysis was performed to rule out the survival of the tibial component.

Results: The mean HSS scores were 45.8 (range 38-60) and 88.1 (range 61-93), preoperatively and at the final follow-up respectively. Complete radiological assessment was performed for 48 knees. Lucent lines at the tibial component were observed in 4 patients; one of these patients underwent a revision surgery due to the loosening of the tibial component. The 10-year survival rate of a tibial component was 98%.

Conclusion: Cementless total knee replacement has satisfactory long term clinical results. Primary fixation of the tibial component with screws provides adequate stability even in elderly patients with good bone quality.

Level of evidence: Level IV, Therapeutic study.

Keywords: Cementless total knee arthroplasty; Hydroxyapatite; Osteolysis; Screw fixation.

MeSH terms

  • Adult
  • Aged
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Arthroplasty, Replacement, Knee* / instrumentation
  • Arthroplasty, Replacement, Knee* / methods
  • Biocompatible Materials / therapeutic use
  • Bone Screws*
  • Durapatite / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint* / diagnostic imaging
  • Knee Joint* / physiopathology
  • Knee Joint* / surgery
  • Knee Prosthesis*
  • Long Term Adverse Effects* / diagnosis
  • Long Term Adverse Effects* / etiology
  • Long Term Adverse Effects* / physiopathology
  • Long Term Adverse Effects* / surgery
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Radiography / methods
  • Recovery of Function
  • Reoperation* / methods
  • Reoperation* / statistics & numerical data
  • Surgical Fixation Devices
  • Tibia / surgery
  • Turkey


  • Biocompatible Materials
  • Durapatite