ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020
Increased survival rate for primary TKA with tibial short extension stems for severe varus deformities at a minimum of 2 years follow-up.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Tibial stem extension versus standard configuration in primary cemented total knee arthroplasty: systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Clinical application of the tibial extension stem in primary TKA for knee varus deformity combined with tibial bone defect.Frontiers in surgery · 2025Article
- Review
- The use of a tibial stem in primary total knee arthroplasty for patients with a frontal deformity of more than ten degrees reduces the rate of postoperative pain.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Similar survival rate but lower functional outcomes following TKA in the elderly people compared to younger patients: analysis of a posterior stabilised implant with minimum 5-year follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties.Medicina (Kaunas, Lithuania) · 2022Article
- HURWA robotic-assisted total knee arthroplasty improves component positioning and alignment - A prospective randomized and multicenter study.Journal of orthopaedic translation · 2022Article
- Semiconstrained posterior-stabilized total knee arthroplasty: indications, risks and benefits in primary and revision surgery.Canadian journal of surgery. Journal canadien de chirurgieReview
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to compare the clinical results, radiographic loosening and early complications between patients undergoing primary knee arthroplasty (TKA) with tibial short stem extension and those with standard stem for gross varus deformities at minimum two years after surgery.
methodsFrom a prospective TKA database of 4216 patients, patients with a primary TKA with a tibial short stem extension (30 mm) for severe varus deformity (hip-kneeankle angle, HKA < 170°) and a minimum follow-up of 2 years, were reviewed and compared to a matched control group with tibial components with a standard stem, in a 1:3 ratio. Demographics, surgical parameters, pre- and postoperative alignment and outcome parameters were collected for all patients. The primary outcome was aseptic loosening of the tibial component. Secondary outcomes were knee society scores (KSS), postoperative HKA, general postoperative complications and implant survival rates.
resultsForty-five patients with tibial short stem extensions (mean HKA 166.2°) were compared in a 1:3 ratio to a matched case-control group of 135 patients with standard stems (mean HKA 167.1°) at a mean follow-up of 57 and 64 months respectively after primary TKA. In the extension stem group, 4 patients encountered complications (8.9%) versus 12 patients in the standard stem group (8.9%). There were no cases of tibial component loosening in the short extension stem versus four cases in the standard stem group (3%). This difference was significant between groups, p = 0.04.
conclusionIn patients with varus deformities > 10°, undergoing primary total knee arthroplasty, prophylactic use of a tibial short extension stem may lead to less loosening of the tibial component. In this study, 3% of patient with big varus deformity without stemmed TKA had a tibial implant loosening versus 0% in the stemmed TKA group. LEVEL OF EVIDENCE: Level III, case-control study.
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