Tibial fixation without screws in cementless total knee arthroplasty.

This study examines the early clinical and radiographic results of the first 216 cases of a cementless fixed bearing tibial tray without screw holes in 191 patients. We hypothesize that stable fixation can be achieved without the use of screws. There were 16 cases lost to follow-up, leaving 200 cases with known outcome. The Hospital for Special Surgery knee scores improved from an average preoperative score of 54/100 to 82/100 postoperatively. Three patients had incomplete radiolucent lines involving the medial aspect of the tibial tray. All of the tibial components reviewed radiographically were bone ingrown. We conclude that the tray provides excellent primary stability, allowing early bone ingrowth, free from osteolysis and with good clinical outcomes. All of the tibial components were bone ingrown by radiographic criteria.