Modular versus nonmodular tibial inserts in total knee arthroplasty: what are the differences?

Although both modular and nonmodular tibial components in primary total knee arthroplasty (TKA) have shown excellent long-term survivorship (1-7), modularity in TKA has been a topic of ongoing debate over the past two decades. The authors of the article entitled “Twenty-Five-Years and Greater, Results After Nonmodular Cemented Total Knee Arthroplasty” should be congratulated for their contribution to the literature (1). The authors have reported the long-term results of nonmodular metal backed cemented tibial insert in 5,649 TKA procedures. The overall prosthesis survival rate was 94.2% at 25 years and 92.4% at 30 years. To the best of our knowledge, these results represent the longest reported follow up for nonmodular metal backed cemented TKAs.