ArticleActa orthopaedica2018
Early aseptic loosening of a mobile-bearing total knee replacement.
Article in Acta orthopaedica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Clinical signs and symptoms of chronic periprosthetic joint infection in the hip and knee: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2026Pooled it
- No difference between mobile and fixed bearing in primary total knee arthroplasty: a meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- The effects of tourniquet on cement penetration in total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2023Trial
- Global trends in fixation methods for primary total knee arthroplasty: An international registry-based analysis and review of outcomes.Journal of orthopaedics · 2025Article
- Polyethylene Insert Wear Leading to Early Aseptic Bilateral Total Knee Arthroplasty Failure: Case Report.Journal of orthopaedic case reports · 2025Article
- Article
- Double-Butter: A Cementation Technique That Significantly Reduces Lipid Contamination of the Tibial Baseplate in Total Knee Arthroplasty.Arthroplasty today · 2024Article
- Isolated aseptic loosening in total knee arthroplasty: a comprehensive 10-year review of partial vs. total component revisions.BMC musculoskeletal disorders · 2024Article
- Is there an increased revision rate due to early tibial component loosening with a modern total knee arthroplasty design? A retrospective analysis from a large volume arthroplasty centre.Arthroplasty (London, England) · 2024Article
- Comprehensive evaluation of risk factors for aseptic loosening in cemented total knee arthroplasty: A systematic review and meta-analysis.Journal of experimental orthopaedics · 2024Review
- Passive Biotelemetric Detection of Tibial Debonding in Wireless Battery-Free Smart Knee Implants.Sensors (Basel, Switzerland) · 2024Article
- Appearance and evolution of radiolucent lines below the tibial implant in primary total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2024Article
- Biomarkers to discriminate between aseptic loosened and stable total hip or knee arthroplasties: a systematic review.EFORT open reviews · 2024Article
- Cementing techniques for total knee arthroplasty in Norwegian hospitals; a questionnaire-based study.BMC musculoskeletal disorders · 2023Article
- The Evolution, Current Indications and Outcomes of Cementless Total Knee Arthroplasty.Journal of clinical medicine · 2022Review
- Robotic-arm assisted total knee arthroplasty has a learning curve of 16 cases and increased operative time of 12 min.ANZ journal of surgery · 2022Article
- Impact of keel saw blade design and thickness on the incidence of tibial plateau fracture and tibial implant-loosening in cementless medial UKR.BMC musculoskeletal disorders · 2022Article
- Does tibial design modification improve implant stability for total knee arthroplasty? An experimental cadaver study.Bone & joint research · 2022Article
- Revision of total knee replacement (TKR) secondary to raised cobalt levels: should this be considered in the painful TKR patient?BMJ case reports · 2021Article
- Implant Interface Debonding After Total Knee Arthroplasty: A New Cause for Concern?Arthroplasty today · 2020Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - Registry-based studies have reported an increased risk of aseptic tibial loosening for the cemented Low Contact Stress (LCS) total knee replacement compared with other cemented designs; however, the reasons for this have not been established. We made a retrieval analysis with the aim of identifying the failure mechanism. Patients and methods - We collected implants, cement, tissue, blood, and radiographs from 32 failed LCS Complete cases. Damage to the tibial baseplate and insert was assessed. Exposure to wear products was quantified in 11 cases through analysis of periprosthetic tissue and blood. Implant alignment and bone cement thickness was compared with a control group of 43 non-revised cases. Results - Loosening of the tibial baseplate was the reason for revision in 25 retrievals, occurring at the implant-cement interface in 16 cases. Polishing was observed on the lower surface of the baseplate and correlated to the level of cobalt, chromium, and zirconium in the blood. No evidence of abnormally high polyethylene wear was present. For each 1 mm increase in cement thickness the odds of failure due to aseptic loosening decreased by 61%. Greater varus alignment was associated with a shorter time to failure. The roughness, Ra, of a new LCS baseplate's lower surface was 3.7 (SD 0.7) µm. Interpretation - Debonding of the tibial component at the implant-cement interface was the predominant cause of tibial aseptic loosening. A thin cement layer may partly explain the poor performance. Furthermore, the comparatively low tibial surface roughness and the lack of a keeled stem may have played a role in the failures observed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.