Stemless constrained total knee arthroplasty: An obsolete concept or a contemporary solution?

Achieving a balanced total knee arthroplasty (TKA) can be challenging when addressing fixed deformities with bone deficiencies and a compromised soft issue envelope. Efforts to achieve ligamentous stability without violating the medullary canal led to the introduction of stemless constrained implants. While a stemless constrained implant is bone conserving and efficient, there are biomechanical concerns of higher failure rates due to increased stresses at the bone–implant interface. The purpose of this study is to review the current literature on stemless constrained implants in TKA and address the controversy around their use.