ArticleBone & joint research2022
Does tibial design modification improve implant stability for total knee arthroplasty? An experimental cadaver study.
Article in Bone & joint research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Consequences of using poly-ether-ether-ketone versus traditional implant on tibial cement penetration and short-term clinical outcomes during total knee arthroplasty: a randomized controlled trial.Journal of orthopaedic surgery and research · 2023Trial
- Robotic-assisted burr preparation significantly improves cement penetration but not immediate fixation strength in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Novel Clinical Applications of 3D-Printed Highly Porous Titanium for Off-the-Shelf Cementless Joint Replacement Prostheses.Biomimetics (Basel, Switzerland) · 2025Article
- Creating Perforations in the Sclerotic Region of the Proximal Tibia During Total Knee Arthroplasty to Enhance Prosthesis Stability.Orthopaedic surgery · 2025Article
- Does the clinical and radiologic outcomes following total knee arthroplasty using a new design cobalt-chrome tibial plate or predecessor different?Knee surgery & related research · 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
- Is TKA femoral implant stability improved by pressure applied cement? a comparison of 2 cementing techniques.BMC musculoskeletal disorders · 2023Article
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Authors and funding
6 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsOne of the main causes of tibial revision surgery for total knee arthroplasty is aseptic loosening. Therefore, stable fixation between the tibial component and the cement, and between the tibial component and the bone, is essential. A factor that could influence the implant stability is the implant design, with its different variations. In an existing implant system, the tibial component was modified by adding cement pockets. The aim of this experimental in vitro study was to investigate whether additional cement pockets on the underside of the tibial component could improve implant stability. The relative motion between implant and bone, the maximum pull-out force, the tibial cement mantle, and a possible path from the bone marrow to the metal-cement interface were determined.
methodsA tibial component with (group S: Attune S+) and without (group A: Attune) additional cement pockets was implanted in 15 fresh-frozen human leg pairs. The relative motion was determined under dynamic loading (extension-flexion 20° to 50°, load-level 1,200 to 2,100 N) with subsequent determination of the maximum pull-out force. In addition, the cement mantle was analyzed radiologically for possible defects, the tibia base cement adhesion, and preoperative bone mineral density (BMD).
resultsThe BMD showed no statistically significant difference between both groups. Group A showed for all load levels significantly higher maximum relative motion compared to group S for 20° and 50° flexion. Group S improved the maximum failure load significantly compared to group A without additional cement pockets. Group S showed a significantly increased cement adhesion compared to group A. The cement penetration and cement mantle defect analysis showed no significant differences between both groups.
conclusionFrom a biomechanical point of view, the additional cement pockets of the component have improved the fixation performance of the implant. Cite this article:
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