Abstract
Over many decades, total knee replacement (TKR) has become the ideal treatment option
for advanced arthritis. Many designs were introduced to increase the stability of
the tibial tray, hence the longevity of the prosthesis. This retrospective study was
performed on 168 patients who received NexGen cemented primary total knee either with
standard tibial tray (group A) or tibial tray with an intramedullary stem (group B)
between May 2008 and May 2017. We reviewed all preoperative and postoperative clinical
and radiological data retrospectively. In addition, a prospective clinical and radiological
reassessment was done. Our aim was to answer the following questions: (1) Is there
any difference between both groups in regard to clinical and radiological results?
(2) Is there any difference in the revision rate? (3) Is there a role of using stemmed
tibial tray in primary TKR? Better results were recorded in obese and severely obese
patients having stemmed cemented tibial tray and so for patients with marked and severe
preoperative varus angle. Our recommendations are to use cemented tibial tray with
a stem in complicated primary surgery without fear of adverse effects on short and
intermediate terms of follow-up.
Keywords
knee replacement - stemmed tibial tray - varus
