Monoblock tibial components in total knee arthroplasty

Backside wear in conventional modular metal-backed tibial components in total knee arthroplasty has been a concern for over a decade. Numerous strategies exist to reduce motion and, therefore, wear at this interface. These include redesigning the locking mechanisms and optimizing the surface finish of modular components using a mobile-bearing tibial component designed to encourage desirable motion and returning to monoblock all-polyethylene and metal-backed tibial components. New designs of monoblock components that may be used with and without cement are available. The most important element of the surgical technique when using these devices is to optimize the exposure of the tibial plateau, including the posterolateral corner, to ensure that correct tibial component rotation is obtained.