Metal Augments, Polyethylene Thickness, and Stem Length Affect Tibial Baseplate Load Transfer in Revision Total Knee Arthroplasty

In complex (severe femoral and tibial metaphyseal bone defects) revision total knee arthroplasties (rTKAs), very good mid-run survivorship of trabecular metal (TM) cones has been reported. The utilization of a short cemented tibial stem combined with a TM cone in rTKA offers identical survival rate than a long uncemented stem associated with TM cones or metallic augments at a minimum of 5 years of follow-up. Hybrid fixation with uncemented diaphyseal-engaging stems and porous tantalum metaphyseal cones results in survivorship of 91.7% at a median follow-up of 33 months when considering all-cause revision as the endpoint. Cemented tibial component, a pegged porous coated cementless tibial component with screws, or a cementless tantalum monoblock tibial component with pegs give similar results at follow-up at 10 years.