Strain shielding in proximal tibia of stemmed knee prosthesis: Experimental study

Completo, António; Fonseca, Fernando; Simões, J. A.

doi:10.1016/j.jbiomech.2007.10.006

Cited by 93 publications

(63 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cemented fixation has the advantage of being able to add antibiotics to the cement, 17 but have disadvantages including the difficulty of removing cement at re-revision should it be necessary, and the potential for stress shielding. Stress shielding has been demonstrated in vitro by Completo, Fonseca and Simões, 18 who compared cemented with non-cemented stems. However, Murray,Rand and Hanssen 19 showed the opposite in their study of sclerotic lines around long cemented stems in 35 patients at 4.8 years of follow-up.…”

Section: Discussionmentioning

confidence: 97%

Mid- to long-term results of revision total knee replacement using press-fit intramedullary stems with cemented femoral and tibial components

Manopoulos

Havet

Pearce

et al. 2012

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

This was a retrospective analysis of the medium-to long-term results of 46 TC3 Sigma revision total knee replacements using long uncemented stems in press-fit mode.Clinical and radiological analysis took place pre-operatively, at two years post-operatively, and at a mean follow-up of 8.5 years (4 to 12). The mean pre-operative International Knee Society (IKS) clinical score was 42 points (0 to 74), improving to 83.7 (52 to 100) by the final follow-up. The mean IKS score for function improved from 34.3 points (0 to 80) to 64.2 (15 to 100) at the final follow-up. At the final follow-up 30 knees (65.2%) had an excellent result, seven (15.2%) a good result, one (2.2%) a medium and eight (17.4%) a poor result. There were two failures, one with anteroposterior instability and one with aseptic loosening.The TC3 revision knee system, when used with press-fit for long intramedullary stems and cemented femoral and tibial components, in both septic and aseptic revisions, results in a satisfactory clinical and radiological outcome, and has a good medium-to long-term survival rate.

show abstract

Section: Discussionmentioning

confidence: 97%

Mid- to long-term results of revision total knee replacement using press-fit intramedullary stems with cemented femoral and tibial components

Manopoulos

Havet

Pearce

et al. 2012

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

show abstract

“…In the literature, no published data from studies measuring BMD using DEXA after rTKA exists; however, experimental strain studies have been published. Completo et al [25] performed an experimental quantification of strain shielding in the proximal synthetic tibia following rTKA. They tested the use of a revision tibial component with cemented (proximal and distal cementation) stem (13 mm×60 mm) and press-fit (proximal cementation) stem (14 mm×115 mm) of the proximal tibia.…”

Section: Discussionmentioning

confidence: 99%

Bone mineral density changes of the proximal tibia after revision total knee arthroplasty. A randomised study with the use of porous tantalum metaphyseal cones

Jensen

Petersen

Schrøder

et al. 2012

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Forty patients were enrolled in a prospective randomised study using conventional method or "Trabecular Metal Cone" (TM Cone) (Zimmer inc., Warsaw, USA) for reconstruction of bone loss of the proximal tibia during revision total knee arthroplasty (rTKA). The aim was to evaluate changes in bone mineral density (BMD) at the proximal tibia. Material and methods Thirty-six patients [median 67 years (range: 40-85 years)] received rTKA with NexGen® (Zimmer Warsaw, USA) revision system. Knee Society´s Knee Scoring System and the Anderson Orthopaedic Research Institute (AORI) bone classification was used. Changes in BMD were measured by dual energy X-ray absorptiometry (DEXA). Results Knee and function score improved in both groups. No significant changes between the groups were found. Changes in BMD within the two groups were quite similar. Overall decreases in BMD of 0.1 -5.4 % were found in both groups (ROI 1-6) postoperative to 12 months of follow-up, except that ROI 7 showed an increase in BMD (0.8 -1.3 %).

show abstract

“…Despite their effectiveness in diaphyseal stem fixation, press-fit stems may give rise to problems, including the need for offset capability when diaphyseal engagement causes implant malalignment, as well as iatrogenic fracture and end of stem pain. Finally, uncemented stems appear to have less of an effect on metaphyseal bone density, although radiolucent lines of uncertain significance can develop around stems over time [14,15].…”

Section: Stem Typesmentioning

confidence: 98%

The role of offset stems in revision knee arthroplasty

Baldini¹,

Balato

Franceschini

2015

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Revision total knee arthroplasty (TKA) represents a technically challenging procedure. The use of an offset stem extension can help in addressing some of the difficulties that can be encountered during surgery and, in particular, anatomical mismatch, malalignment, and gap balancing. Different offset stem extensions are available and can be classified according to four parameters: modularity, location of the offset, direction, and size of the displacement. Offset stem extensions can assist with implant alignment on the metaphysis if there is an offset diaphysis, can avoid medial-lateral or anterior-posterior component overhang, can reduce the incidence of coronal or sagittal malalignment, and can help in balancing the flexion and extension spaces by effectively translating the components. The aim of this study is to give an overview of the currently available evidence regarding the use of offset stem extensions in revision TKA as well as some useful surgical tips.

show abstract

Strain shielding in proximal tibia of stemmed knee prosthesis: Experimental study

Cited by 93 publications

References 27 publications

Mid- to long-term results of revision total knee replacement using press-fit intramedullary stems with cemented femoral and tibial components

Mid- to long-term results of revision total knee replacement using press-fit intramedullary stems with cemented femoral and tibial components

Bone mineral density changes of the proximal tibia after revision total knee arthroplasty. A randomised study with the use of porous tantalum metaphyseal cones

The role of offset stems in revision knee arthroplasty

Contact Info

Product

Resources

About