Effects of implant precoating and fat contamination on the stability of the tibial baseplate.
Knee
; 49: 266-278, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-39059126
ABSTRACT
BACKGROUND:
Approximately 5% of primary total knee arthroplasty patients require revision within 10 years, often due to distal component loosening. Application of a thin layer of PMMA cement as precoating on the tibial component aims to prevent aseptic loosening. This study investigates the impact of precoating and fat contamination on tibial baseplate stability.METHODS:
Two groups of NexGen® stemmed tibial implants (size 4) were studied Option implants (N = 12) and PMMA Precoat implants (N = 12). Each implant design was divided into two subgroups, (N = 6), with one subgroup featuring bone marrow fat at the implant-cement interface and the other without contamination. In a mechanical testing machine, the implants underwent uniaxial loading for 20,000 cycles, while recording vertical micromotion and migration of the tibial baseplates. Subsequently, a push-out test assessed fixation strength at the cement interfaces. Results were compared using non-parametric statistics and presented as median and min-to-max ranges.RESULTS:
Option implants exhibited higher micromotion in dry conditions compared to precoated implants (p = 0.03). Under contamination, both designs demonstrated similar micromotion values. Fixation strength did not significantly differ between designs under dry, uncontaminated conditions (p > 0.99). However, under contaminated conditions, the failure load for the non-coated Option implant was nearly half that of the uncontaminated counterparts (3517 N, 2603-4367 N vs 7531 N, 5163-9000 N; p = 0.002). Precoat implants displayed less susceptibility to fat contamination (p = 0.30).CONCLUSION:
NexGen® implant PMMA precoating might reduce the risk of aseptic loosening and revision surgery in case of eventual bone-marrow fat contamination.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prosthesis Design
/
Tibia
/
Bone Cements
/
Prosthesis Failure
/
Arthroplasty, Replacement, Knee
/
Knee Prosthesis
Limits:
Humans
Language:
En
Journal:
Knee
Journal subject:
ORTOPEDIA
Year:
2024
Document type:
Article
Country of publication:
Netherlands