The Effect of Surface Morphology on the Primary Fixation Strength of Uncemented Femoral Knee Prosthesis: A Cadaveric Study

Berahmani, Sanaz; Janssen, Dennis; Wolfson, David; Rivard, K.; Malefijt, M.C. de Waal

doi:10.1016/j.arth.2014.09.030

Cited by 17 publications

(33 citation statements)

References 22 publications

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“…One possible reason for the limited amount of research is probably the excellent long‐term outcome of femoral knee implants . However, recent applications of new materials such as ceramic and PEEK, or the application of new porous materials at the interface necessitates development of new pre‐clinical testing approaches. In addition, the distal femur is subjected to a complex loading regime during different ADLs, in which the position and direction of the contact loads change constantly, which requires the utilization of a sophisticated experimental set‐up.…”

Section: Discussionmentioning

confidence: 99%

FE analysis of the effects of simplifications in experimental testing on micromotions of uncemented femoral knee implants

Berahmani

Janssen

Wolfson³

et al. 2015

J. Orthop. Res.

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Experimental testing of orthopaedic implants requires simplifications concerning load application and activities being analyzed. This computational study investigated how these simplifications affect micromotions at the bone-implant interface of an uncemented femoral knee implant. As a basis, validated in vivo loads of the stance phase of gait and a deep knee bend were adopted. Eventually, three configurations were considered: (i) simulation of the complete loading cycle; (ii) inclusion of only tibiofemoral loads (ignoring patellofemoral loads); and (iii) applying only a single peak tibiofemoral force. For all loading conditions the largest micromotions found at the proximal anterior flange. Without the patellofemoral force, peak micromotions increased 6% and 22% for gait and deep knee bend, respectively. By applying a single peak tibiofemoral force micromotions were overestimated. However, the peak micromotions corresponded to the maximum tibiofemoral force, and strong micromotion correlations were found between a complete loading cycle and a single peak load (R 2 ¼ 0.73 and R 2 ¼ 0.89 for gait and deep knee bend, respectively). Deep knee bend resulted in larger micromotions than gait. Our study suggests that a simplified peak force can be used to assess the stability of cementless femoral components. For more robust testing, implants should be subjected to different loading modes. ß

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Section: Discussionmentioning

confidence: 99%

FE analysis of the effects of simplifications in experimental testing on micromotions of uncemented femoral knee implants

Berahmani

Janssen

Wolfson³

et al. 2015

J. Orthop. Res.

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“…12,13 The porous surface provides a mechanical interlock, which limits micromotion. The initial stability obtained at surgery influences eventual longterm fixation, 14 which is important as the presence of micromotion compromises the chance of achieving osseointegration. 15,16 Hydroxyapatite (HA) coating.…”

Section: Cementless Tkamentioning

confidence: 99%

Cementless total knee arthroplasty

Dalury

2016

The Bone & Joint Journal

121

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As the number of younger and more active patients treated with total knee arthroplasty (TKA) continues to increase, consideration of better fixation as a means of improving implant longevity is required. Cemented TKA remains the reference standard with the largest body of evidence and the longest follow-up to support its use. However, cementless TKA, may offer the opportunity of a more bone-sparing procedure with long lasting biological fixation to the bone. We undertook a review of the literature examining advances of cementless TKA and the reported results. Cite this article: Bone Joint J 2016;98-B:867-73.

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“…Cementless implants rely on a porous or roughened surface to facilitate bone formation. The initial stability obtained at surgery influences long-term fixation [ 13 ], which is important to prevent micromotion compromising the chance of achieving osseointegration.…”

Section: Discussionmentioning

confidence: 99%

Cemented or cementless total knee arthroplasty?

Prudhon¹,

Verdier

2017

SICOT-J

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Introduction: Since 1996 we have been using cementless fixation with hydroxyapatite (HA) coating. The purpose of this paper is to compare survivorship of a series of 100 cemented Total Knee Arthroplasty (TKA) to a similar series of 100 cementless with a follow up of 11–16 years. Material methods: Both TKA are mobile bearing total knee postero-stabilized. They can be used with cement or without cement. Among 1030 New Wave TKATM implanted from 2002 to 2015 we have identified 100 cemented TKAs and 100 cementless TKAs. All these cases were primary replacement. Differences in survival probability were determined using log-rank test. Results: Survival probabilities at 11 years of follow-up were: Cemented group: 90.2% CI95% [81.9–94.8]; Cementless group: 95.4% CI95% [88.1–98.2]. Comparison between both group showed significant difference, p = 0.32. Discussion: The advantages of cementless TKA are bone stock preservation, cement debris protection and the potential to achieve biologic fixation. Cementless implants rely on a porous or roughened surface to facilitate bone formation. HA has been shown to accelerate bone integration and to decrease micro motion of the components and to increase fixation. With a survival probability of 90.2% (cemented version) and 95.4% (cementless version), this total knee prosthesis performs as intended in primary total knee arthroplasty. No statistical differences could be found between cemented and cementless implants.

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The Effect of Surface Morphology on the Primary Fixation Strength of Uncemented Femoral Knee Prosthesis: A Cadaveric Study

Cited by 17 publications

References 22 publications

FE analysis of the effects of simplifications in experimental testing on micromotions of uncemented femoral knee implants

FE analysis of the effects of simplifications in experimental testing on micromotions of uncemented femoral knee implants

Cementless total knee arthroplasty

Cemented or cementless total knee arthroplasty?

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