A Prospective Randomized Clinical Trial Comparing Tibial Baseplate Fixation With or Without Screws in Total Knee Arthroplasty

In a randomized prospective study, we compared the use of tibial screws with screwless tibial baseplate fixation in uncemented total knee arthroplasty and report the results of 154 prostheses at a mean follow-up of 5 years. Patients were mobilized within 24 hours and continued with partial weight-bearing for up to 6 weeks postoperatively. There were no significant differences in radiologic results and revision rates. Radiographic outcomes do not seem to be influenced by the use of screws in tibial baseplate fixation of this prosthesis. The prosthesis studied has a large tibial keel and 4 adjunctive pegs that seem to provide adequate stability and allow bony ingrowth to take place. Longer follow-up will determine whether in this implant design, the use of tibial screws for cementless tibial baseplate fixation can be justified.