{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:20:16Z","timestamp":1786357216592,"version":"build-2736575974"},"reference-count":37,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroplastyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Arthroplasty"],"published-print":{"date-parts":[[2020,10]]},"DOI":"10.1016\/j.arth.2020.05.068","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T18:52:42Z","timestamp":1591123962000},"page":"3031-3037","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"title":["Metaphyseal Stem Extension Improves Tibial Stability in Cementless Total Knee Arthroplasty"],"prefix":"10.1016","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1061-5968","authenticated-orcid":false,"given":"Michael P.","family":"Morwood","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Guss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesua I.","family":"Law","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher E.","family":"Pelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.arth.2020.05.068_bib1","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2106\/00004623-200704000-00012","article-title":"Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030","volume":"89","author":"Kurtz","year":"2007","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2020.05.068_bib2","doi-asserted-by":"crossref","first-page":"60","DOI":"10.5312\/wjo.v9.i4.60","article-title":"Why total knees fail-A modern perspective review","volume":"9","author":"Lum","year":"2018","journal-title":"World J Orthop"},{"key":"10.1016\/j.arth.2020.05.068_bib3","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1016\/j.arth.2013.07.024","article-title":"Why are total knee arthroplasties failing today--has anything changed after 10 years?","volume":"29","author":"Sharkey","year":"2014","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s11999-009-0945-0","article-title":"The epidemiology of revision total knee arthroplasty in the United States","volume":"468","author":"Bozic","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2020.05.068_bib5","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1302\/0301-620X.97B6.35185","article-title":"Dealing with the predicted increase in demand for revision total knee arthroplasty: challenges, risks and opportunities","volume":"97\u2013b","author":"Hamilton","year":"2015","journal-title":"Bone Joint J"},{"key":"10.1016\/j.arth.2020.05.068_bib6","doi-asserted-by":"crossref","first-page":"2181","DOI":"10.1016\/j.arth.2015.06.057","article-title":"Increased aseptic tibial Failures in patients With a BMI >\/=35 and well-aligned total knee arthroplasties","volume":"30","author":"Abdel","year":"2015","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib7","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1016\/j.arth.2016.12.001","article-title":"Catastrophic varus collapse of the tibia in obese total knee arthroplasty","volume":"32","author":"Fehring","year":"2017","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib8","doi-asserted-by":"crossref","first-page":"263","DOI":"10.3928\/01477447-20180815-05","article-title":"Cementless total knee arthroplasty: a comprehensive review of the literature","volume":"41","author":"Newman","year":"2018","journal-title":"Orthopedics"},{"key":"10.1016\/j.arth.2020.05.068_bib9","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1016\/j.arth.2016.12.023","article-title":"Cementless vs cemented tibial fixation in primary total knee arthroplasty","volume":"32","author":"Behery","year":"2017","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib10","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/j.arth.2017.11.048","article-title":"Results of cemented vs cementless primary total knee arthroplasty using the same implant design","volume":"33","author":"Miller","year":"2018","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib11","first-page":"28","article-title":"Cementless total knee arthroplasty in patients over 65 years old","author":"Hofmann","year":"1991","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2020.05.068_bib12","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/00003086-200211000-00018","article-title":"Cementless total knee arthroplasty in patients 50 years or younger","author":"Hofmann","year":"2002","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2020.05.068_bib13","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1302\/0301-620X.91B7.21702","article-title":"Survival and clinical function of cemented and uncemented prostheses in total knee replacement: a meta-analysis","volume":"91","author":"Gandhi","year":"2009","journal-title":"J\u00a0Bone Joint Surg Br"},{"key":"10.1016\/j.arth.2020.05.068_bib14","doi-asserted-by":"crossref","first-page":"864","DOI":"10.2106\/00004623-199274060-00007","article-title":"Osteolysis after total knee arthroplasty without cement","volume":"74","author":"Peters","year":"1992","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2020.05.068_bib15","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/00003086-198607000-00023","article-title":"Observations on the effect of movement on\u00a0bone ingrowth into porous-surfaced implants","author":"Pilliar","year":"1986","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2020.05.068_bib16","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/jor.1100100216","article-title":"Tissue ingrowth into titanium and hydroxyapatite-coated implants during stable and unstable mechanical conditions","volume":"10","author":"Soballe","year":"1992","journal-title":"J\u00a0Orthop Res"},{"key":"10.1016\/j.arth.2020.05.068_bib17","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1302\/0301-620X.94B8.28289","article-title":"The role of the design of tibial components and stems in knee replacement","volume":"94","author":"Scott","year":"2012","journal-title":"J\u00a0Bone Joint Surg Br"},{"key":"10.1016\/j.arth.2020.05.068_bib18","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.arth.2010.01.107","article-title":"Cementing the tibial component in total knee arthroplasty: which technique is the best?","volume":"26","author":"Vanlommel","year":"2011","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib19","doi-asserted-by":"crossref","first-page":"2556","DOI":"10.1016\/j.arth.2017.03.039","article-title":"Initial stability of cemented vs cementless tibial components under cyclic load","volume":"32","author":"Crook","year":"2017","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib20","first-page":"45","article-title":"Clinical and radiologic effects of diaphyseal stem extension in noncemented total knee replacement","volume":"38","author":"Cameron","year":"1995","journal-title":"Can J Surg"},{"key":"10.1016\/j.arth.2020.05.068_bib21","doi-asserted-by":"crossref","first-page":"442","DOI":"10.5435\/00124635-200808000-00003","article-title":"Revision total knee arthroplasty","volume":"16","author":"Dennis","year":"2008","journal-title":"J\u00a0Am Acad Orthop Surg"},{"key":"10.1016\/j.arth.2020.05.068_bib22","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.knee.2018.02.011","article-title":"Influence of stem length on component flexion and posterior condylar offset in revision total knee arthroplasty","volume":"25","author":"Ettinger","year":"2018","journal-title":"Knee"},{"key":"10.1016\/j.arth.2020.05.068_bib23","doi-asserted-by":"crossref","first-page":"S209","DOI":"10.1016\/j.arth.2017.05.039","article-title":"Optimizing mechanical alignment with modular stems in revision TKA","volume":"32","author":"Fleischman","year":"2017","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib24","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s11999-014-3529-6","article-title":"A\u00a030-mm cemented stem extension provides adequate fixation of the tibial component in revision knee arthroplasty","volume":"473","author":"Lachiewicz","year":"2015","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2020.05.068_bib25","doi-asserted-by":"crossref","first-page":"3644","DOI":"10.1007\/s00167-016-4271-2","article-title":"Tibial component with and without stem extension in a trabecular metal cone construct","volume":"25","author":"Meijer","year":"2017","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.arth.2020.05.068_bib26","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s11999-016-4791-6","article-title":"Do stemmed tibial components in total knee arthroplasty improve outcomes in patients with obesity?","volume":"475","author":"Parratte","year":"2017","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2020.05.068_bib27","doi-asserted-by":"crossref","first-page":"2512","DOI":"10.1016\/j.arth.2018.03.058","article-title":"Using a tibial short extension stem reduces tibial component loosening after primary total knee arthroplasty in severely varus knees: long-term survival analysis with propensity score matching","volume":"33","author":"Park","year":"2018","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib28","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1007\/s00264-018-4191-5","article-title":"Primary cementless total knee arthroplasty with or without stem extension: a matched comparative study of ninety eight standard stems versus ninety eight long stems after more than ten years of follow-up","volume":"43","author":"Prudhon","year":"2018","journal-title":"Int Orthop"},{"key":"10.1016\/j.arth.2020.05.068_bib29","doi-asserted-by":"crossref","first-page":"227","DOI":"10.5792\/ksrr.18.022","article-title":"Prophylactic tibial stem fixation in the obese: comparative early results in primary total knee arthroplasty","volume":"30","author":"Steere","year":"2018","journal-title":"Knee Surg Relat Res"},{"key":"10.1016\/j.arth.2020.05.068_bib30","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1016\/j.arth.2011.06.010","article-title":"Micromotion of cementless tibial baseplates under physiological loading conditions","volume":"27","author":"Bhimji","year":"2012","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib31","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/j.arth.2014.02.016","article-title":"Micromotion of cementless tibial baseplates: keels with adjuvant pegs offer more stability than pegs alone","volume":"29","author":"Bhimji","year":"2014","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.05.068_bib32","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/0021-9290(83)90097-0","article-title":"The mechanical properties of human tibial trabecular bone as a function of metaphyseal location","volume":"16","author":"Goldstein","year":"1983","journal-title":"J\u00a0Biomech"},{"key":"10.1016\/j.arth.2020.05.068_bib33","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1002\/jbm.820280503","article-title":"Mineral apposition rates of human cancellous bone at the interface of porous coated implants","volume":"28","author":"Bloebaum","year":"1994","journal-title":"J\u00a0Biomed Mater Res"},{"key":"10.1016\/j.arth.2020.05.068_bib34","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.2106\/JBJS.K.00927","article-title":"Influence of limb alignment on mediolateral loading in total knee replacement: in vivo measurements in five patients","volume":"94","author":"Halder","year":"2012","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2020.05.068_bib35","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.1002\/jor.20255","article-title":"Contributions of muscles, ligaments, and the ground-reaction force to tibiofemoral joint loading during normal gait","volume":"24","author":"Shelburne","year":"2006","journal-title":"J\u00a0Orthop Res"},{"key":"10.1016\/j.arth.2020.05.068_bib36","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1007\/s11999-014-3540-y","article-title":"Current modes of failure in TKA: infection, instability, and stiffness predominate","volume":"472","author":"Le","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2020.05.068_bib37","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12891-018-1977-y","article-title":"Analysis of total knee arthroplasty revision causes","volume":"19","author":"Postler","year":"2018","journal-title":"BMC Musculoskelet Disord"}],"container-title":["The Journal of Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540320306094?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540320306094?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:31:41Z","timestamp":1760121101000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883540320306094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":37,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["S0883540320306094"],"URL":"https:\/\/doi.org\/10.1016\/j.arth.2020.05.068","relation":{},"ISSN":["0883-5403"],"issn-type":[{"value":"0883-5403","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Metaphyseal Stem Extension Improves Tibial Stability in Cementless Total Knee Arthroplasty","name":"articletitle","label":"Article Title"},{"value":"The Journal of Arthroplasty","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arth.2020.05.068","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}