Abstract
Due to the known potential for fretting and corrosion at modular junctions in orthopaedic implants, this retrospective study evaluated radiographic and clinical outcomes of 85 primary TKA patients implanted with modular stemmed tibial components and followed up for an average of 82 months. There was low incidence of tibial radiolucent lines, excellent functional outcomes, and no complications associated with stem modularity. The findings were comparable to the historical control study involving 107 TKA with a nonmodular tibial stem design. When using surface cemented tibial components combined with a constrained polyethylene bearing, modular stems appear to be a viable option for primary TKA when adequate fixation and rotational stability are maintained.
Highlights
Central stems on tibial components in total knee arthroplasty (TKA) can exist in many different lengths and shapes
The aim of this study is to evaluate clinical outcomes at the 2-to-11-year follow-up interval for a consecutive series of primary TKA patients implanted using a single prosthesis design having a cemented tibial baseplate with five pegs and a short modular stem attached via a Morse taper and Advances in Orthopedics (a)
Because this study is focused on primary TKA, we identified a historical control study inclusive of a comparable TKA design with similar tibial component features, except for the stem modularity [29]
Summary
Central stems on tibial components in total knee arthroplasty (TKA) can exist in many different lengths (short < 50 mm; long > 50 mm) and shapes (e.g., cruciform keels, I-beams, and cylinders). Some tibial component designs offer stem modularity, providing surgeons intraoperative flexibility to accommodate variable bone quality through attachment of differently shaped short modular stems for use in primary TKA [8,9,10] or long modular intramedullary stems when addressing bone deficiencies in revision knee arthroplasty [10, 11]. Surgeons often restrict modular stem use to revision knee arthroplasty or to primary TKA cases with gross malalignment or osseous defects [12, 13]. Given recent heightened clinical concerns related to modularity and the potential for adverse tissue responses to metal debris [19, 20, 23,24,25,26,27,28], ongoing vigilance of primary TKA having tibial components with modular stems is warranted
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