Background: A total knee arthroplasty with a four-peg tibial baseplate is an uncommonly used contemporary design. Potential advantages of this baseplate include preservation of host bone, compatibility with minimally invasive techniques, and easier removal with revision techniques. The purpose of this study was to determine the long-term results of a contemporary total knee arthroplasty that included a four-peg tibial baseplate.

Methods: From February 1995 to December 1996, 127 total knee arthroplasties were performed by one surgeon in 115 patients with an average age of seventy years. Clinical and radiographic evaluations were performed with use of the Knee Society scoring system at a minimum of ten years following replacement. Complications were identified by means of chart review and screening for readmission at surrounding institutions.

Results: At the time of follow-up, at a minimum of ten years after the arthroplasty, thirty patients (with thirty-three involved knees) were documented to have died and four patients (with seven involved knees) could not be located. The next-of-kin of the patients who had died directly confirmed that the knee was unrevised at the time of death. Eighty-seven knees in eighty-one patients remained available for evaluation after a minimum of ten years of follow-up. Two knees had failed: one had a late infection at three years, and one had aseptic loosening at seven years. The rate of survival free of revision at ten years was 97%. Knee Society knee and function scores averaged 94 and 75 points, respectively. None of the remaining knees had radiographic evidence of loosening.

Conclusions: This study demonstrated excellent, durable clinical and radiographic results at a minimum of ten years after replacement with this cemented, modular, fixed-bearing, cruciate-retaining total knee prosthesis with a four-peg tibial baseplate. We believe that this design is an acceptable option for total knee arthroplasty.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.