INTRODUCTION: Improving the longevity and reliability of cemented total knee arthroplasty (TKA) remains a major step to achieve. It is still unclear, whether a cemented tibial stem reduces micromotion of the tibial tray and produces therefore a better initial stability or not. The higher conformity of rotating platform design and the possible rotary forces to the tibial platform may produce higher micromotion when the tibial stem remains cementless (hybrid fixation). MATERIALS AND METHODS: An in vitro study was performed using the PFC mobile bearing tibial tray (DePuy, Warswa, IN, USA) to test the hypothesis that the addition of cement surrounding the tibial stem reduces micromotion of the tibial tray in cemented TKA with mobile bearing design. Ten tibial trays with mobile design were implanted in sawbones with a 3-mm cement mantle beneath the baseplate of the tibial tray and with or without the cemented stem. Tibial trays were loaded additionally in the ventral, lateral, medial and posterior positions with 2,500 N using the Zwick Z010 instrumentation and HBM pick up Hottinger Baldwin. RESULTS: In this study, a significant increased mean maximum liftoff was found when only cementing the tibial baseplate (hybrid fixation), compared to the fully cemented tibial tray (P<0.02). CONCLUSION: In conclusion, the stem of mobile bearing tibial components should be cemented to provide increased micromotion and earlier loosening.
INTRODUCTION: Improving the longevity and reliability of cemented total knee arthroplasty (TKA) remains a major step to achieve. It is still unclear, whether a cemented tibial stem reduces micromotion of the tibial tray and produces therefore a better initial stability or not. The higher conformity of rotating platform design and the possible rotary forces to the tibial platform may produce higher micromotion when the tibial stem remains cementless (hybrid fixation). MATERIALS AND METHODS: An in vitro study was performed using the PFC mobile bearing tibial tray (DePuy, Warswa, IN, USA) to test the hypothesis that the addition of cement surrounding the tibial stem reduces micromotion of the tibial tray in cemented TKA with mobile bearing design. Ten tibial trays with mobile design were implanted in sawbones with a 3-mm cement mantle beneath the baseplate of the tibial tray and with or without the cemented stem. Tibial trays were loaded additionally in the ventral, lateral, medial and posterior positions with 2,500 N using the Zwick Z010 instrumentation and HBM pick up Hottinger Baldwin. RESULTS: In this study, a significant increased mean maximum liftoff was found when only cementing the tibial baseplate (hybrid fixation), compared to the fully cemented tibial tray (P<0.02). CONCLUSION: In conclusion, the stem of mobile bearing tibial components should be cemented to provide increased micromotion and earlier loosening.
Authors: M J F Diks; P G Anderson; J C A D Janssen; G van Stralen; A B Wymenga Journal: Knee Surg Sports Traumatol Arthrosc Date: 2007-11-14 Impact factor: 4.342
Authors: Adrian Skwara; J Figiel; T Knott; J R J Paletta; S Fuchs-Winkelmann; C O Tibesku Journal: Knee Surg Sports Traumatol Arthrosc Date: 2009-07-02 Impact factor: 4.342
Authors: Turgay Efe; Jens Figiel; David Sibbert; Susanne Fuchs-Winkelmann; Carsten O Tibesku; Nina Timmesfeld; Jürgen R J R Paletta; Adrian Skwara Journal: BMC Musculoskelet Disord Date: 2011-01-10 Impact factor: 2.362
Authors: Christopher E Pelt; Jill Erickson; Bryt A Christensen; Benjamin Widmer; Erik P Severson; David Evans; Christopher L Peters Journal: Biomed Res Int Date: 2014-05-14 Impact factor: 3.411
Authors: Anders M Refsum; Uy V Nguyen; Jan-Erik Gjertsen; Birgitte Espehaug; Anne M Fenstad; Regina K Lein; Peter Ellison; Paul J Høl; Ove Furnes Journal: Acta Orthop Date: 2019-08-27 Impact factor: 3.717
Authors: Sebastian Jaeger; Marvin Eissler; Martin Schwarze; Mareike Schonhoff; J Philippe Kretzer; Rudi G Bitsch Journal: Bone Joint Res Date: 2022-04 Impact factor: 4.410