Initial Stability of Cemented vs Cementless Tibial Components Under Cyclic Load

Abstract Background Cement fixation of total knee components remains the gold standard despite resurgence in cementless fixation with the goal of long-term durable fixation. Initial stability is paramount to achieve bony ingrowth of cementless components. Methods Twelve cemented and cementless tibia...

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Bibliographic Details
Published in:	The Journal of arthroplasty 2017-08, Vol.32 (8), p.2556-2562
Main Authors:	Crook, Paul D., MD, Owen, John R., MS, Hess, Shane R., DO, Al-Humadi, Samer M., BS, Wayne, Jennifer S., PhD, Jiranek, William A., MD
Format:	Article
Language:	eng
Subjects:	arthroplasty Arthroplasty, Replacement, Knee - instrumentation Bone Cements cemented cementless Humans knee Knee Joint - physiology Knee Joint - surgery Knee Prosthesis Orthopedics Prosthesis Design Tibia - surgery total knee arthroplasty Weight-Bearing
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Summary:	Abstract Background Cement fixation of total knee components remains the gold standard despite resurgence in cementless fixation with the goal of long-term durable fixation. Initial stability is paramount to achieve bony ingrowth of cementless components. Methods Twelve cemented and cementless tibial baseplates were implanted into sawbones and tested using a physiological medial-lateral load distribution for 10,000 cycles to represent 8 weeks of in vivo function. Micromotion was measured at 5 locations around the baseplate during loading. Results Cycling had a significant effect on the change in micromotion between maximum and minimum loads at the anterior, medial, lateral, posteromedial, and posterolateral tray edge locations. A significant effect of fixation technique was detected for the anterior ( P < .001), medial ( P = .002), and lateral ( P = .0056) locations but not for the posteromedial ( P = .36) or posterolateral ( P = .82) locations. Differences in micromotion between cemented and cementless components did not exceed 150 μm at any tested location. Conclusion The micromotion experienced by cementless tibial components in the present study may indicate a lower initial mechanical stability than the cemented group. However, this difference in initial stability may be subclinical because the differences between average cemented and cementless micromotion were
ISSN:	0883-5403 1532-8406