Primary stability of unicompartmental knee arthroplasty under dynamic compression-shear loading in human tibiae

Grupp, Thomas M.; Pietschmann, Matthias F.; Holderied, M.; Scheele, Christian; Schröder, Christian; Jansson, Volkmar; Müller, Peter E.

doi:10.1016/j.clinbiomech.2013.10.003

Cited by 16 publications

(11 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Um die Knochenzementinterdigitation zu optimieren, bohren wir sklerotische Knochenoberflächen mit einem 2,0-mm-Bohrer an, reinigen die Oberflä-chen mit pulsierender CO 2 -oder Wasserlavage [11] und wählen eine doppelte Zementiertechnik auf Knochen und Implantat. Diese Strategie wird durch Daten aus der Knietotalprothetik gestützt [38], konnte bisher bei UKA jedoch keinen klaren Benefit zeigen [13]. Vor Zementierung der Komponenten platzieren wir eine Kompresse im posterioren Rezessus, um eine Zementprotrusion nach posterior zu verhindern.…”

Section: Zementieren Der Komponentenunclassified

Moderne unikondyläre Kniearthroplastik

Knoch

Munzinger

2014

Orthopäde

View full text Add to dashboard Cite

Zusammenfassung Hintergrund Die unikondyläre Kniearthroplastik (UKA) ist bei fortgeschrittener medialer oder lateraler Gonarthrose eine etablierte Therapieoption. Ziel der Arbeit Die Eckpfeiler einer erfolgreichen UKA – sorgfältige Patientenselektion, präoperative Planung und präzise Operationstechnik – werden in dieser Übersichtsarbeit behandelt. Stellenwert Im Unterschied zur Knietotalarthroplastik erlaubt die UKA den Erhalt des kontralateralen und patellofemoralen Kompartiments sowie der Kreuzbänder und ist oft mit einer rascheren postoperativen Erholung, verbesserten Kniekinematik und Kniefunktion verbunden. Allerdings ist die UKA technisch sehr anspruchsvoll. Hohe Revisionsraten wurden v. a. bei breiter Anwendung gemäß nationaler Prothesenregister berichtet. Schlussfolgerung Der Erfolg der UKA hängt von einer sorgfältigen Patientenauswahl, detaillierten präoperativen Planung und Operationstechnik ab. Eine Erweiterung der klassischen Indikationskriterien für UKA halten wir für gerechtfertigt. Drei Typen der mechanischen Varus-Valgus-Deformität vor medialer oder lateraler UKA können unterschieden werden: Typ 1 (isolierte intraartikuläre Deformität), Typ 2 (übermäßige Deformität durch extraartikuläre Varusdeformität bei medialer UKA oder Valgusdeformität bei lateraler UKA), Typ 3 (reduzierte Deformität durch extraartikuläre Valgusdeformität bei medialer UKA oder Varusdeformität bei lateraler UKA). Diese Deformitäten sollten bei der Operationstechnik berücksichtigt werden.

show abstract

Section: Zementieren Der Komponentenunclassified

Moderne unikondyläre Kniearthroplastik

Knoch

Munzinger

2014

Orthopäde

View full text Add to dashboard Cite

show abstract

“…1 study found no statistically significant difference comparing application onto bone versus bone and prosthesis, when studying properties of the cement interface and mechanical load to failure using a UKA model (Grupp et al. 2013). Another study favored cement application onto the prosthesis only over cement application onto the bone only, comparing percentage of cement penetration at different levels in porcine tibial bone (Bauze et al.…”

Section: Resultsmentioning

confidence: 99%

Cementing technique for primary knee arthroplasty: a scoping review

et al. 2019

View full text Add to dashboard Cite

Background and purpose — The optimal cementing technique for primary total knee arthroplasty (TKA) remains unclear. We therefore performed a scoping review based on available studies regarding cementation technique in primary TKA and unicondylar knee arthroplasty (UKA).Patients and methods — A search in 3 databases identified 1,554 studies. The inclusion criteria were literature that studied cementing technique in primary TKA or UKA. This included cement application methods, full or surface cementing, applying cement to the bone and/or prosthesis, stabilization of the implant during curing phase, bone irrigation technique, drilling holes in the bone, use of suction, and the timing of cementation. 57 studies met the inclusion criteria.Results — The evidence was unanimously in favor of pulsatile lavage irrigation, drying the bone, and drilling holes into the tibia during a TKA. All studies concerning suction recommended it during TKA cementation. 7 out of 11 studies favored the use of a cement gun and no studies showed that finger packing was statistically significantly better than using a cement gun. There is evidence that full cementation should be used if metal-backed tibial components are used. Applying the cement to both implant and bone seems to give better cement penetration.Interpretation — There are still many knowledge gaps regarding cementing technique in primary TKA. There seems to be sufficient evidence to recommend pulsatile lavage irrigation of the bone, drilling multiple holes, and drying the bone before cementing and implant insertion, and applying cement to both implant and on the bone.

show abstract

“…Concerning the metal artifact reduction technique, we used a protocol developed by Meinel et al (2012) [22]. The reference method of a histological evaluation of cuts through the cement-bone-interface has already been established in former studies [23–26].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of a non-invasive CT-based measuring technique for cement penetration depth in human tibial UKA

et al. 2019

Self Cite

View full text Add to dashboard Cite

BackgroundAseptic loosening of the tibial component remains a major cause of failure in unicompartmental knee arthroplasty (UKA) and may be related to micro-motion at the cement-bone interface due to insufficient cement penetration depth. Cement penetration is therefore taken as an indicator of solid fixation strength and primary stability. However, its non-invasive clinical assessment remains difficult in vivo as conventional x-ray is prone to distortion and CT-scans (computed tomography) are difficult to assess due to metal artifacts. The purpose of this study was to develop and validate a reliable in vivo measuring technique of cement penetration depth in human tibial UKA.MethodsIn an experimental setting, twelve UKA were implanted in fresh-frozen human cadaver knees using a minimal-invasive medial approach. Cement penetration depth was then measured via 1) virtual 3D-models based on metal artifact reduced CT-scans and 2) histological evaluation of nine serial cross-section cuts through the implant-cement-bone-interface. Subsequently, a concordance analysis between the two measuring techniques was conducted.ResultsThe average cement penetration depth was 1) 2.20 mm (SD 0.30 mm) measured on metal artifact reduced CT-scans and 2) 2.21 mm (SD = 0.42) measured on serial cuts (p = 0.956). The mean difference between both techniques was 0.01 mm (SD 0.31 mm) and the Person correlation coefficient was r = 0.686 (p = 0.014). All differences were within the upper and lower limit of agreement. There was no evidence of any significant proportional bias between both techniques (p = 0.182).ConclusionsCT-based non-invasive measurement of cement penetration depth delivers reliable results in measuring the penetration depth in tibial UKA. Thereby, it enables clinicians and researchers to assess the cement penetration for in vivo diagnostics in the clinical setting as well as in vitro biomechanical research with subsequent application of load to failure on the implant-cement-bone-interface.

show abstract

Primary stability of unicompartmental knee arthroplasty under dynamic compression-shear loading in human tibiae

Cited by 16 publications

References 31 publications

Moderne unikondyläre Kniearthroplastik

Moderne unikondyläre Kniearthroplastik

Cementing technique for primary knee arthroplasty: a scoping review

Accuracy of a non-invasive CT-based measuring technique for cement penetration depth in human tibial UKA

Contact Info

Product

Resources

About