Tibial Component Fixation in Deficient Tibial Bone Stock

Brooks, Peter J.; Walker, Peter S.; Scott, Richard D.

doi:10.1097/00003086-198404000-00049

Cited by 192 publications

(118 citation statements)

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“…The augment stem still provided increased support to axial and bending loads, in agreement with our previous findings [16]. Our results also agree with those of Brooks et al [4], who performed in vitro axial and varus loading tests on cadaveric tibiae in which defects had been created and then filled with different materials. The least deflection of the tibial tray in their study occurred when a custom tibial component was used.…”

Section: Discussionsupporting

confidence: 93%

Stemmed Implants Improve Stability in Augmented Constrained Condylar Knees

Rawlinson

Closkey²,

Davis

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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We previously combined experimental and computational measures to ascertain whether tibial stem augmentation reduces bone strains beneath constrained condylar implants. Using these same integrated approaches, we examined the benefit of a stem when a wedge is used. Implants were removed from the eight paired cadaver specimens from our previous experiment, and oblique defects created that were restored with 15°metallic wedges cemented in place. We applied a varus moment and an axial load and monitored relative motion between implant and bone. Specimen-specific 3-D finite element models were constructed from CT scans and radiographs to examine bone stress in the proximal tibia. Implants with a wedge but no stem had greater motion than the previous control with no stem or wedge. Use of a modular stem with a wedge maintained the same level of motion as the primary case, suggesting that a stem is preferable when a wedge is utilized. The computational models confirmed this conclusion with a 30% reduction in bone stress compared to 17% in the primary case without a wedge. The wedge carried more axial load compared to the primary implant due to its support on stiff metaphyseal bone.

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Section: Discussionsupporting

confidence: 93%

Stemmed Implants Improve Stability in Augmented Constrained Condylar Knees

Rawlinson

Closkey²,

Davis

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…Thus Walker et al (1981) found micromotion up to 0.2 mm using axial loads of three times body weight and a rotatory torque of 23 Nm. Brooks et al (1984) found maximum deflections of 0.09 mm measured over 10 mm bone substance, using a force of 1780 N in a study on the significance of different designs in the presence of deficient bone stock. Thus, the inducible displacement occurred in the interfaces.…”

Section: The Site For Micromotionmentioning

confidence: 98%

Micromotion in knee arthroplasty

Ryd

1986

Acta Orthopaedica Scandinavica

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1.The coordinate system for unicompartmental and total prostheses. 2. The Venn diagram used in the Lund assessment system. 3. Total Condylar knee prosthesis. 17 4. Modular (Marmor) knee prosthesis. 5. Kinematic Migration:original position to a new resting position. Inducible displacement:the prosthesis is detachable from its resting position. Rigid body:Rigid-body model (RBM): A configuration of three or more non-collinear markers representing the bodies of interest (prostheses or bone segments), and used for calculation of movements.

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“…Some authors (Lotke et al, 1991;Ritter et al, 1993) have observed good medium or long term results, while others (Brooks et al, 1984;Freeman et al, 1982;Insall & Ealsey, 2001) had obtained poor ones. Moreover these studies showed that weak biomechanical characters of cement do not improve in resistance of the implant with use of support screws.…”

Section: Cement Fillingmentioning

confidence: 99%

“…The use of metal augments for bone deficiencies has become quite popular since mid Eighties, after the work of Brooks et al which indicated that biomechanically the modular augments are equivalent to a custom implant (Brooks et al, 1984). In last decades a new biomaterial is largely used in knee prosthetic surgery: porous tantalum, in its trabecular form (trabecular metal, TM; Zimmer, Warsaw, Ind, US).…”

Section: Modular Components (Metal Augments)mentioning

confidence: 99%