Initial Stability of Cemented vs Cementless Tibial Components Under Cyclic Load.
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 <150 μm at all measured locations under the loading regime implemented.
Crook, PD; Owen, JR; Hess, SR; Al-Humadi, SM; Wayne, JS; Jiranek, WA
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