Use of screws and cement in primary TKA with up to 20 years follow-up.
The purpose of this study was to investigate screws and cement for large tibial bone defects during primary TKA. Of 14,686 consecutive primary TKAs performed between December 1988 and February 2010, 256 received screws and cement for tibial defects. Cox regression was used for the analysis. 20-year survival probability was 0.9897 (screws) and 0.9339 (no screws) (P = .4225 log-rank). Tibial bone condition was significantly worse in knees receiving screws (P < .0001) with 73.0% having defects in the screws group and 3.4% (P < .0001) for non-screws. Radiolucency appeared in 13.7% (screws) and 6.4% (no screws) postoperatively. Screws were $137 each, wedges $910 to $2240. Knees with tibial defects and screws performed similarly if not better than knees without defects at substantially lower cost than alternatives.
The Center for Hip and Knee Surgery St. Francis Hospital, Mooresville, Indiana.
Michael E
ME
Berend
The Center for Hip and Knee Surgery St. Francis Hospital, Mooresville, Indiana.
Merrill A
MA
Ritter
The Center for Hip and Knee Surgery St. Francis Hospital, Mooresville, Indiana.
E Michael
EM
Keating
The Center for Hip and Knee Surgery St. Francis Hospital, Mooresville, Indiana.
Michael D
MD
Jackson
The Center for Hip and Knee Surgery St. Francis Hospital, Mooresville, Indiana.
Kenneth E
KE
Davis
D001168:Arthritis / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee; D001843:Bone Cements; D001862:Bone Resorption / Q000601:surgery; D001863:Bone Screws; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*
D001843:Bone Cements
costs; screws; tibial defects; total knee arthroplasty; wedges