Good long-term results following cementless TKA with a titanium plasma coating.
OBJECTIVE
While cemented total knee arthroplasty (TKA) is currently the gold standard for primary osteoarthritis, cementless component fixation has achieved increasingly comparable outcomes due to improvements in both implant designs and surgical technique. Long-term outcomes and survivorship with the TC-Plus cementless, titanium plasma-coated TKA system without patella resurfacing were evaluated.


METHODS
A homogenous population of 171 consecutive patients who received 206 primary TC-Plus TKAs without patella resurfacing over a 19-year period was retrospectively reviewed. Knee Society Clinical Rating System (KSCRS) scores were obtained, and radiographic evaluation was performed after a mean follow-up of 13.2 ± 8.4 years. Survivorship analysis was made with endpoints revision for any reason and aseptic loss of biological fixation.


RESULTS
One hundred and thirty-six TKAs implanted in 113 patients were available for analysis. Mean KSCRS clinical and functional scores improved significantly versus preoperative values. No radiological loss of biological fixation of femoral and tibial components was observed. Survival with aseptic revision of any component as the endpoint was 95.7 % (95 % confidence interval (CI) 91.7-97.9 %) and 93.6 % (95 % CI 87.8-96.6 %) at 10 and 15 years, respectively.


CONCLUSIONS
Titanium plasma-coated cementless TKA without patella resurfacing showed excellent long-term results, with high 10- and 15-year component survival rates. The clinical and radiological results were comparable to those of other cementless TKAs, providing further evidence for the non-cemented resurfacing of the osteoarthritic knee.


METHODS
IV.
Orthopaedic Department, General Hospital of Patras, Tsertidou 1, 26335, Patras, Greece.
Theodore
T
Bouras
Orthopaedic Department, General Hospital of Patras, Tsertidou 1, 26335, Patras, Greece.
Vasileios
V
Bitas
AMR Advanced Medical Research, Hofenstrasse 89b, 8708, Männedorf, Switzerland.
Peter
P
Fennema
Orthopaedic Department, General Hospital of Patras, Tsertidou 1, 26335, Patras, Greece. korovess@otenet.gr.
Panagiotis
P
Korovessis
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods*; D001672:Biocompatible Materials; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010329:Patella / Q000601:surgery; D010949:Plasma; D011474:Prosthesis Design; D011859:Radiography; D012189:Retrospective Studies; D014025:Titanium; D016896:Treatment Outcome
D001672:Biocompatible Materials; D014025:Titanium
Biocompatible coated materials; Osteoarthritis; Prosthesis design; Survivorship; Total knee arthroplasty