Initial Stability of Cemented vs Cementless Tibial Components Under Cyclic Load

Crook, Paul D; Owen, John R.; Hess, Shane R.; Al-Humadi, Samer; Wayne, Jennifer S.; Jiranek, William A.

doi:10.1016/j.arth.2017.03.039

Cited by 20 publications

(8 citation statements)

References 59 publications

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“…While cementless tibial components may have a lower initial mechanical stability compared with the cemented components, this difference may be subclinical because the differences between average cementless and cemented micromotion were found to be <150 μm under cyclic loading regime. 38 The clinical data further supports the favorable performance of newer cementless TKA. Additionally, since cementless implants may preserve better bone stock in the hypothetical case of revision surgery, they may present a competitive advantage to cemented implants, which require more bone resection during revision surgery, compared with cementless implants.…”

Section: Discussionmentioning

confidence: 72%

Survivorship and Functional Outcomes of Cementless versus Cemented Total Knee Arthroplasty: A Meta-Analysis

et al. 2019

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The purpose of this meta-analysis was to assess the evidence supporting the use of cementless versus cemented total knee arthroplasties (TKAs). Specifically, we evaluated (1) all-cause survivorship, (2) aseptic survivorship, and (3) functional outcomes (Knee Society Scores [KSS], Oxford Knee Scores, Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] scores, and ranges of motion [ROMs]). A literature search was performed for studies that evaluated cementless versus cemented TKAs published between 2000 and 2017. Selected studies included three randomized controlled trials, three retrospective observational studies, and one prospective observational study that met the following criteria: (1) primary TKAs, (2) compared cementless and cemented TKAs, (3) implant survivorship that described the causes of failure, and (4) at least one functional outcome. To compare the two cohorts, pooled odds ratios (OR) and 95% confidence intervals (95% CI) were used to calculate tibial and femoral implant survivorship, and pooled mean differences (MD) and 95% CI calculated the functional scores and ROMs. Based on pooled data from the few number of studies, cementless TKAs had a better all-cause survivorship (OR = 0.37; 95% CI, 0.15–0.92) and tended to have a better aseptic survivorship (OR = 0.44; 95% CI, 0.17–1.14). However, this is likely due to the 83.3% weight of the single cementless study potentially influencing the analysis. There were no differences in terms of KSS knee (MD = 1.03; 95% CI, −1.13–3.20) or function scores (MD = 5.36; 95% CI, –3.75–14.51), Oxford knee scores (MD = 0.36; 95% CI, –3.84–4.56), or WOMAC scores (MD = 0.62; 95% CI, –0.87–2.11). Moreover, there was no difference in ROMs (MD = 1.47; 95% CI, –0.11–3.05). Cementless TKA had a better all-cause survivorship when compared with cemented fixation, and similar functional outcomes were demonstrated. However, these findings are based on only a few number of studies (n = 7). Therefore, additional prospective, randomized control trials need to be performed to best compare cementless versus cemented outcomes.

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Section: Discussionmentioning

confidence: 72%

Survivorship and Functional Outcomes of Cementless versus Cemented Total Knee Arthroplasty: A Meta-Analysis

et al. 2019

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“…However, aseptic loosening continues to be the leading cause of revision for TKA, accounting for 31%-39% of revision cases [ 1 , 2 ]. Cement fixation provides robust initial fixation; however, it is subject to tensile and shear forces, which are not well tolerated and can lead to micromotion and component loosening [ 25 , 26 ]. Cementless fixation provides the opportunity for biologic ingrowth with the potential for long-term remodeling and eliminates the risk of cement particle third-body debris [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Multiacquisition Variable-Resonance Image Combination Magnetic Resonance Imaging to Study Detailed Bone Apposition and Fixation of Cementless Knee System Compared to Cemented Total Knee Replacements

et al. 2022

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“…The instability of the prosthesis will not only affect the bone growth, resulting in loosening of the prosthesis [47], but it will also affect the adhesion of bacteria due to the unstable shear force [26]. In clinical practice, the application of cementless TKA is limited because it may be associated with higher loosening and revision rates than cemented TKA for lower initial stability [48]. Although cementless fixation is reliable according to many studies [49, 50], it may not be determinable by radiography whether the prosthesis has fretting within a short follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Prosthesis design of animal models of periprosthetic joint infection following total knee arthroplasty: A systematic review

Deng

Cao

et al. 2019

PLoS ONE

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BackgroundThe number of periprosthetic joint infections (PJI) after total knee arthroplasty (TKA) is increasing annually. Animal models have been used to clarify their clinical characteristics and the infection mechanism of pathogenic bacteria, However, since the prosthesis design of animal models is not uniform, it is difficult to simulate the environment of clinical PJI.ObjectivesTo retrospect the progress on the prosthesis design of animal models of PJI after TKA and to summarize the criteria for evaluating a clinically representative model of PJI.MethodsThis systematic review was reported on the basis of Systematic Reviews and Meta-Analyzes (PRISMA). Pubmed, EMbase, Cochrane Library, Web of Science, Wanfang Data and China National Knowledge Infrastructure were researched for animal models of PJI after TKA from database establishment to April 2019 according to Chinese and English retrieval words, including “periprosthetic joint infections and total knee arthroplasty,” “periprosthetic joint infections and model,” “periprosthetic joint infections and biofilm,” and “total knee arthroplasty and model.”ResultsA total of 12 quantitative studies were enrolled in our study finally: 8 representative studies described prosthesis designs used in PJI animal models, 4 studies described prosthesis designs in non-infected animal models which were suitable for infection models. The major problems need to be dealed with were prosthesis, installation location, material, the function of separating the articular and medullary cavity, fixation manner, and the procedure of preserving the posterior cruciate ligament.ConclusionA highly representative design of the animal prosthesis of PJI should meet the following criteria: the surface of the prosthesis is smooth with the formation of biofilm, composed of titanium-6Al-4V or cobalt-chromium-molybdenum alloy; prosthesis can bear weight and is highly stable; and it can connect the joint cavity and medullary cavity simultaneously. To reach a more reliable conclusion, further experiments and improvements are required.

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Initial Stability of Cemented vs Cementless Tibial Components Under Cyclic Load

Cited by 20 publications

References 59 publications

Survivorship and Functional Outcomes of Cementless versus Cemented Total Knee Arthroplasty: A Meta-Analysis

Survivorship and Functional Outcomes of Cementless versus Cemented Total Knee Arthroplasty: A Meta-Analysis

Multiacquisition Variable-Resonance Image Combination Magnetic Resonance Imaging to Study Detailed Bone Apposition and Fixation of Cementless Knee System Compared to Cemented Total Knee Replacements

Prosthesis design of animal models of periprosthetic joint infection following total knee arthroplasty: A systematic review

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