Modular revision systems have become standard in revision TKAs. However, the type of stem fixation remains controversial. The purpose of this study is to compare the incidence of failure between cemented and diaphyseal engaging cementless stems in aseptic revision TKAs. We performed a multicenter retrospective review of 82 revision TKAs performed for aseptic failure. Follow-up averaged 76 and 121 months for the cemented and cementless groups respectively. Re-revision and radiographic failure rates for both femoral and tibial stems were similar between groups. We found similar improvements in knee society scores between the groups. At midterm follow-up, we found no difference in failure rates between the groups. Both types of stem appear to provide reliable fixation and are viable options in revision TKAs.
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