Does tibial design modification improve implant stability for total knee arthroplasty?

• Verfasst von: Jäger, Sebastian [VerfasserIn]
• Verfasst von: Eissler, Marvin [VerfasserIn]
• Verfasst von: Schwarze, Martin [VerfasserIn]
• Verfasst von: Schonhoff, Mareike [VerfasserIn]
• Verfasst von: Kretzer, Jan Philippe [VerfasserIn]
• Verfasst von: Bitsch, Rudi G. [VerfasserIn]
• Titel: Does tibial design modification improve implant stability for total knee arthroplasty?
• Titelzusatz: An experimental cadaver study
• Verf.angabe: Sebastian Jaeger, Marvin Eissler, Martin Schwarze, Mareike Schonhoff, J. Philippe Kretzer, Rudi G. Bitsch
• E-Jahr: 2022
• Jahr: 11 Apr 2022
• Umfang: 10 S.
• Fussnoten: Gesehen am 17.08.2022
• Titel Quelle: Enthalten in: Bone & joint research
• Ort Quelle: London : British Editorial Soc. of Bone & Joint Surgery, 2012
• Jahr Quelle: 2022
• Band/Heft Quelle: 11(2022), 4, Seite 229-238
• ISSN Quelle: 2046-3758
• DOI: doi:10.1302/2046-3758.114.BJR-2021-0169.R1
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aseptic loosening
• Sach-SW: Attune
• Sach-SW: Attune S+
• Sach-SW: bone marrow
• Sach-SW: bone mineral density (BMD)
• Sach-SW: Cement debonding
• Sach-SW: Cement pockets
• Sach-SW: flexion
• Sach-SW: Implant stability
• Sach-SW: metal
• Sach-SW: Revision surgeries
• Sach-SW: stable fixation
• Sach-SW: tibia
• Sach-SW: tibial components
• Sach-SW: total knee arthroplasty
• K10plus-PPN: 181453329X

Abstract

Aims - - One of the main causes of tibial revision surgery for total knee arthroplasty is aseptic loosening. Therefore, stable fixation between the tibial component and the cement, and between the tibial component and the bone, is essential. A factor that could influence the implant stability is the implant design, with its different variations. In an existing implant system, the tibial component was modified by adding cement pockets. The aim of this experimental in vitro study was to investigate whether additional cement pockets on the underside of the tibial component could improve implant stability. The relative motion between implant and bone, the maximum pull-out force, the tibial cement mantle, and a possible path from the bone marrow to the metal-cement interface were determined. - - Methods - - A tibial component with (group S: Attune S+) and without (group A: Attune) additional cement pockets was implanted in 15 fresh-frozen human leg pairs. The relative motion was determined under dynamic loading (extension-flexion 20° to 50°, load-level 1,200 to 2,100 N) with subsequent determination of the maximum pull-out force. In addition, the cement mantle was analyzed radiologically for possible defects, the tibia base cement adhesion, and preoperative bone mineral density (BMD). - - Results - - The BMD showed no statistically significant difference between both groups. Group A showed for all load levels significantly higher maximum relative motion compared to group S for 20° and 50° flexion. Group S improved the maximum failure load significantly compared to group A without additional cement pockets. Group S showed a significantly increased cement adhesion compared to group A. The cement penetration and cement mantle defect analysis showed no significant differences between both groups. - - Conclusion - - From a biomechanical point of view, the additional cement pockets of the component have improved the fixation performance of the implant. - - Cite this article: Bone Joint Res 2022;11(4):229-238.