CORR Insights®: Higher Risk of Loosening for a Four-Pegged TKA Tibial Baseplate Than for a Stemmed One: A Register-based Study

摘要

In their large study from the Swedish Knee Arthroplasty Register, Robertsson and colleagues [6] assessed the risk of revision following use of a particular cemented TKA design (NexGen®-CR Option; Zimmer, Warsaw, IN, USA), which used a cemented tibial component available in two versions: One with a central keel, and the other with four short pegs. The authors found that the all-cause cumulative revision rates were higher in the pegged TKA group than in the stemmed TKA cohort. The finding of increased risk of revisions is not entirely surprising, as there are other reports, with other implant designs, demonstrating increased risk of aseptic loosening with short-keeled cemented tibial implants [4, 5]. Furthermore, mechanical testing in cadavers has identified that central stems of varying lengths are helpful in reducing tibial subsidence with axial loads, and improved resistance to shear forces [8].