Does using autograft bone chips achieve consistent bone ingrowth in primary TKA?

Background: Cementless fixation remains controversial in TKA due to the challenge of achieving consistent skeletal attachment. Factors predicting durable fixation are not clearly understood, but we presumed bone ingrowth could be enhanced by the quantity of host bone and application of autograft bone chips.

Questions/purposes: We asked: (1) Did the amount of bone ingrowth exceed the amount of periprosthetic and host bone with the addition of autograft bone chips? (2) Did the amount of bone ingrowth increase with implantation time? And (3) did osteolysis along the porous-coated interface and screw tracts progress with implantation time?

Methods: We measured the amount of bone in the porous-coated, periprosthetic, and host bone regions in 19 postmortem retrieved cementless primary total knee implants.

Histologic retrieval analysis of a porous tantalum metal implant in an infected primary total knee arthroplasty.

Porous tantalum (Zimmer, Inc, Warsaw, Ind) has the theoretical advantage of improved biologic fixation because of its high porosity, interconnected pore space, and modulus of elasticity. We present a case report documenting the retrieval and bone ingrowth analysis of a porous tantalum tibial component in an infected total knee arthroplasty. Results demonstrated a significantly larger amount of bone ingrowth present in the tibial posts (36.

Characterization of the anchoring morphology and mineral content of the anterior cruciate and medial collateral ligaments of the knee.

The manner in which ligament connects to bone remains an area of interest for researchers, bioengineers, and clinicians. Stable fixation of an anterior cruciate ligament (ACL) graft has been shown to be paramount to preventing excess anterior tibial translation and to restoring the normal kinematics of the knee joint. In this study, the surface area of attachment and the mineral characteristics of the ACL and medial collateral ligament (MCL) attachment sites were characterized to determine the factors that contributed to ligament attachment strength.

A Method for Cemented Bone Interface Examination Without Polymethylmethacrylate Embedment.

Although effective, the embedment of bone tissue and orthopaedic devices using polymethylmethacrylate (PMMA) has challenges and limitations. To embed using PMMA, specimens must first be fixed in 70% ethanol, dehydrated in ascending grades of ethanol, and then infiltrated and polymerized in polymethylmethacrylate using standard techniques. This process can take more than 22 d for large bone specimens.

Does celecoxib have an adverse effect on bone remodeling and ingrowth in humans?

Although celecoxib may provide perioperative pain relief, the effect of the short-term use of celecoxib on bone ingrowth into porous-coated devices has not been previously studied in humans. Bone ingrowth into titanium and tantalum plugs was measured in nine patients who underwent staged bilateral total knee arthroplasty (TKA) and were taking celecoxib as part of a perioperative pain relief protocol. Patients were given tetracycline to measure the mineral apposition rate before and after celecoxib administration.