Rigidity of initial fixation with uncemented tibial knee implants

Branson, Philip J.; Steege, J. W.; Wixson, Richard L.; Lewis, Jack L.; Stulberg, S. David

doi:10.1016/s0883-5403(89)80049-x

Cited by 40 publications

(4 citation statements)

References 12 publications

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“…Several authors have studied the inducible changes in position under various conditions, and a relatively larger inducible displacement is considered a poor prognostic sign of an implant. [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] To the authors' knowledge, only 1 study compares the inducible change of uncemented tibias to that of cemented tibias; Wilson et al 58 showed that uncemented Trabecular Metal components had a lower inducible change than its cemented counterparts.…”

Section: Trabecular Metalmentioning

confidence: 99%

Comparison of Cemented and Uncemented Fixation in Total Knee Arthroplasty

Brown

Harper²,

Bjørgul³

2013

Orthopedics

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As a result of reading this article, physicians should be able to :1. Understand the rationale behind using uncemented fixation in total knee arthroplasty.2.Discuss the current literature comparing cemented and uncemented total knee arthroplasty3. Describe the value of radiostereographic analysis in assessing implant stability.4. Appreciate the limitations in the available literature advocating 1 mode of fixation in total knee arthroplasty. Total knee arthroplasty performed worldwide uses either cemented, cementless, or hybrid (cementless femur with a cemented tibia) fixation of the components. No recent literature review concerning the outcomes of cemented vs noncemented components has been performed. Noncemented components offer the potential advantage of a biologic interface between the bone and implants, which could demonstrate the greatest advantage in long-term durable fixation in the follow-up of young patients undergoing arthroplasty. Several advances have been made in the backing of the tibial components that have not been available long enough to yield long-term comparative follow-up studies. Short-term radiostereographic analysis studies have yielded differing results. Although long-term, high-quality studies are still needed, material advances in biologic fixation surfaces, such as trabecular metal and hydroxyapatite, may offer promising results for young and active patients undergoing total knee arthroplasty when compared with traditional cemented options.

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Section: Trabecular Metalmentioning

confidence: 99%

Comparison of Cemented and Uncemented Fixation in Total Knee Arthroplasty

Brown

Harper²,

Bjørgul³

2013

Orthopedics

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“…Initial tibial designs achieved fixation with short pegs, which were inadequate to obtain sufficient mechanical stability to facilitate osseointegration and instead promoted lift-off and subsidence. 9,49,63 Moran et al 45 reported a series of cementless porous-coated anatomic knee arthroplasties (PCA; Howmedica, Rutherford, NJ) and documented a 19% failure rate at an average 64-month follow-up. All failures were due to the tibial component and consisted of collapse of the anteromedial tibia with subsidence, aseptic loosening, and severe polyethylene wear.…”

Section: Past Present and Futurementioning

confidence: 99%

Cementless Fixation in Total Knee Arthroplasty –Past, Present, and Future

Meneghini

2008

J Knee Surg

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“…Cadaver studies of knee and hip prostheses have demonstrated micromovements between bone and implant in the range of 100-600 prn at loads in the low physiologic range (Shimagaki et al 1988, Strickland et al 1988, Volz et al 1988, Branson et al 1989, Vanderby et al 1989, Burke et al 1991. We have recently reported a dog model for studies of controlled movements between bone and implant (Seballe et al 1990(Seballe et al , 1992 where a fibrous membrane occurred around implants subjected to micromovements of 500 prn, whereas bone ingrowth was found around stable control implants.…”

Section: Hydroxyapat I Te Coating Mod If Ies Implant Membrane Formatimentioning

confidence: 99%