{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:05Z","timestamp":1787755265128,"version":"build-2784847793"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,5,16]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although tibial component loosening has been considered a concern after total knee arthroplasty without cement, such implants have been used in younger patients because of the potential for ingrowth and preservation of bone stock. However, mid-term and long-term studies of modern uncemented implants are lacking. We previously reported promising prospective 5-year outcomes after using an uncemented porous tantalum tibial component in patients who underwent surgery before the age of 60 years. The purpose of this study was to determine clinical and radiographic implant survivorship at 10 years in this large series of young patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The original cohort included 79 patients (96 knees) who were &lt;60 years old at the time of surgery. All procedures were performed with an uncemented, posterior-stabilized femoral component and a porous tantalum monoblock tibial component by 1 high-volume arthroplasty surgeon at a single institution. Patients were followed prospectively. The Knee Society Score (KSS), radiographic findings, and any complications or revisions were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At the latest follow-up, 76% (60) of the 79 patients (74% [71] of the 96 knees) were available for evaluation or had undergone revision (n = 6); 7 patients had died with the implants in place, and 12 patients were lost to follow-up. The average follow-up for the available implants was 10 years (range, 8 to 12 years). There were no progressive radiolucencies on radiographic review. The mean functional KSS was 68 points (range, 0 to 100 points). All revisions were for reasons unrelated to tibial fixation: femoral component loosening (1), stiffness (1), pain and swelling (2), and instability (2). The all-cause revision rate was 6% (6 of 96 knees).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Uncemented porous tantalum monoblock tibial components provided reliable fixation, excellent radiographic findings, and satisfactory functional outcomes at a mean of 10 years postoperatively. We identified no cases of tibial component loosening. These promising clinical and radiographic results support the use of uncemented tibial components. Such implants may produce well-integrated, durable long-term constructs in young patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.00724","type":"journal-article","created":{"date-parts":[[2018,5,16]],"date-time":"2018-05-16T19:20:59Z","timestamp":1526498459000},"page":"865-870","source":"Crossref","is-referenced-by-count":34,"title":["Uncemented Tantalum Monoblock Tibial Fixation for Total Knee Arthroplasty in Patients Less Than 60 Years of Age"],"prefix":"10.2106","volume":"100","author":[{"given":"Christopher J.","family":"DeFrancesco","sequence":"first","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 A.","family":"Canseco","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles L.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig L.","family":"Israelite","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9214-2756","authenticated-orcid":false,"given":"Atul F.","family":"Kamath","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20230911","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/00003086-200111000-00024","article-title":"Problems with cementless total knee arthroplasty at 11 years followup","volume":"392","author":"Berger","year":"2001","journal-title":"Clin Orthop Relat Res."},{"issue":"2","key":"bib2-20230911","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1302\/0301-620X.77B2.7706337","article-title":"Osteolysis around cementless porous-coated anatomic knee prostheses","volume":"77","author":"Kim","year":"1995","journal-title":"J Bone Joint Surg Br."},{"issue":"4","key":"bib3-20230911","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1302\/0301-620X.77B4.7677886","article-title":"Osteolysis around cementless porous-coated knee prostheses","volume":"77","author":"Moran","year":"1995","journal-title":"J Bone Joint Surg Br."},{"issue":"6","key":"bib4-20230911","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 Bone Joint Surg Am."},{"issue":"10","key":"bib5-20230911","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1016\/j.arth.2016.01.043","article-title":"Twenty-five-years and greater, results after nonmodular cemented total knee arthroplasty","volume":"31","author":"Ritter","year":"2016","journal-title":"J Arthroplasty."},{"issue":"8","key":"bib6-20230911","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.arth.2011.06.030","article-title":"Prospective results of uncemented tantalum monoblock tibia in total knee arthroplasty: minimum 5-year follow-up in patients younger than 55 years","volume":"26","author":"Kamath","year":"2011","journal-title":"J Arthroplasty."},{"issue":"1","key":"bib7-20230911","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s11999-014-3585-y","article-title":"The Mark Coventry Award: trabecular metal tibial components were durable and reliable in primary total knee arthroplasty: a randomized clinical trial","volume":"473","author":"Pulido","year":"2015","journal-title":"Clin Orthop Relat Res."},{"issue":"10","key":"bib8-20230911","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1016\/j.arth.2016.03.057","article-title":"Total knee arthroplasty using cementless porous tantalum monoblock tibial component: a minimum 10-year follow-up","volume":"31","author":"De Martino","year":"2016","journal-title":"J Arthroplasty."},{"issue":"5","key":"bib9-20230911","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1302\/0301-620X.81B5.0810907","article-title":"Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial","volume":"81","author":"Bobyn","year":"1999","journal-title":"J Bone Joint Surg Br."},{"issue":"27","key":"bib10-20230911","doi-asserted-by":"crossref","first-page":"4671","DOI":"10.1016\/j.biomaterials.2006.04.041","article-title":"Experimental and clinical performance of porous tantalum in orthopedic surgery","volume":"27","author":"Levine","year":"2006","journal-title":"Biomaterials."},{"issue":"5","key":"bib11-20230911","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1080\/17453674.2016.1205169","article-title":"Trabecular metal tibial knee component still stable at 10 years","volume":"87","author":"Henricson","year":"2016","journal-title":"Acta Orthop."},{"issue":"1","key":"bib13-20230911","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.arth.2004.11.002","article-title":"The early innovators of today\u2019s resurfacing condylar knees","volume":"20","author":"Robinson","year":"2005","journal-title":"J Arthroplasty."},{"issue":"4","key":"bib14-20230911","first-page":"218","article-title":"History of total knee replacement","volume":"11","author":"Ranawat","year":"2002","journal-title":"J South Orthop Assoc."},{"issue":"1","key":"bib15-20230911","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/S0030-5898(20)30270-4","article-title":"The porous-coated anatomic total knee","volume":"13","author":"Hungerford","year":"1982","journal-title":"Orthop Clin North Am."},{"issue":"9","key":"bib16-20230911","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1016\/j.arth.2013.03.005","article-title":"Early failure of cementless porous tantalum monoblock tibial components","volume":"28","author":"Meneghini","year":"2013","journal-title":"J Arthroplasty."},{"issue":"8","key":"bib17-20230911","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.arth.2013.04.056","article-title":"Why are total knees failing today? Etiology of total knee revision in 2010 and 2011","volume":"28","author":"Schroer","year":"2013","journal-title":"J Arthroplasty."},{"key":"bib18-20230911","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/01.blo.0000214421.21712.62","article-title":"Current etiologies and modes of failure in total knee arthroplasty revision","volume":"446","author":"Mulhall","year":"2006","journal-title":"Clin Orthop Relat Res."},{"key":"bib19-20230911","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/01.blo.0000214416.91216.77","article-title":"Socioeconomic issues and demographics of total knee arthroplasty revision","volume":"446","author":"Saleh","year":"2006","journal-title":"Clin Orthop Relat Res."},{"issue":"11","key":"bib20-20230911","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1302\/0301-620X.96B11.34327","article-title":"Cementless total knee replacement fixation: a contemporary durable solution\u2014affirms","volume":"96-B","author":"Kwong","year":"2014","journal-title":"Bone Joint J."},{"issue":"1","key":"bib21-20230911","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.arth.2009.12.008","article-title":"Uncemented tibial fixation total knee arthroplasty","volume":"26","author":"Cossetto","year":"2011","journal-title":"J Arthroplasty."},{"key":"bib22-20230911","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/00003086-199203000-00008","article-title":"The prosthesis-bone interface in total knee arthroplasty","volume":"276","author":"Matthews","year":"1992","journal-title":"Clin Orthop Relat Res."},{"issue":"6","key":"bib23-20230911","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1016\/j.arth.2013.01.035","article-title":"Acknowledged Contributors: Ingrowth Retrieval Study Group. Bone ingrowth in well-fixed retrieved porous tantalum implants","volume":"28","author":"Hanzlik","year":"2013","journal-title":"J Arthroplasty."},{"issue":"8","key":"bib24-20230911","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/S0883-5403(97)90162-5","article-title":"Postmortem analysis of consecutively retrieved asymmetric porous-coated tibial components","volume":"12","author":"Bloebaum","year":"1997","journal-title":"J Arthroplasty."},{"key":"bib25-20230911","first-page":"179","article-title":"Bilateral tibial components of different cementless designs and materials. Microradiographic, backscattered imaging, and histologic analysis","volume":"268","author":"Bloebaum","year":"1991","journal-title":"Clin Orthop Relat Res."},{"issue":"8","key":"bib26-20230911","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 Arthroplasty."},{"issue":"10","key":"bib27-20230911","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1007\/s11999-009-1222-y","article-title":"Do porous tantalum implants help preserve bone?: evaluation of tibial bone density surrounding tantalum tibial implants in TKA","volume":"468","author":"Harrison","year":"2010","journal-title":"Clin Orthop Relat Res."},{"issue":"2","key":"bib28-20230911","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s00264-015-2852-1","article-title":"Changes in bone mineral density of the proximal tibia after uncemented total knee arthroplasty. A prospective randomized study","volume":"40","author":"Winther","year":"2016","journal-title":"Int Orthop."},{"issue":"3","key":"bib29-20230911","doi-asserted-by":"crossref","first-page":"700","DOI":"10.2106\/JBJS.H.01349","article-title":"Comparison of bone mineral density between porous tantalum and cemented tibial total knee arthroplasty components","volume":"92","author":"Minoda","year":"2010","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib30-20230911","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.arth.2016.09.011","article-title":"Cementless porous tantalum monoblock tibia vs cemented modular tibia in primary total knee arthroplasty: a meta-analysis","volume":"32","author":"Hu","year":"2017","journal-title":"J Arthroplasty."},{"issue":"18","key":"bib31-20230911","doi-asserted-by":"crossref","first-page":"e159","DOI":"10.2106\/JBJS.M.01259","article-title":"Total knee replacement in young, active patients: long-term follow-up and functional outcome: a concise follow-up of a previous report","volume":"96","author":"Long","year":"2014","journal-title":"J Bone Joint Surg Am."},{"issue":"12","key":"bib32-20230911","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1016\/j.arth.2015.05.052","article-title":"Long-term survivorship and clinical outcomes following total knee arthroplasty","volume":"30","author":"Jauregui","year":"2015","journal-title":"J Arthroplasty."},{"issue":"24","key":"bib33-20230911","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.2106\/JBJS.16.00093","article-title":"Effect of body mass index on reoperation and complications after total knee arthroplasty","volume":"98","author":"Wagner","year":"2016","journal-title":"J Bone Joint Surg Am."},{"issue":"8","key":"bib34-20230911","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1016\/j.arth.2016.01.025","article-title":"Cemented vs Cementless total knee arthroplasty in morbidly obese patients","volume":"31","author":"Bagsby","year":"2016","journal-title":"J Arthroplasty."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201805160-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:40:19Z","timestamp":1787751619000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201805160-00008"}},"subtitle":["Mean 10-Year Follow-up"],"short-title":[],"issued":{"date-parts":[[2018,5,16]]},"references-count":33,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.17.00724","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,16]]}}}