Background: Cement fixation of total knee components remains the gold standard despite resurgence in cementless fixation with the goal of long-term durable fixation. Initial stability is paramount to achieve bony ingrowth of cementless components.
Methods: Twelve cemented and cementless tibial baseplates were implanted into sawbones and tested using a physiological medial-lateral load distribution for 10,000 cycles to represent 8 weeks of in vivo function. Micromotion was measured at 5 locations around the baseplate during loading.
Results: Cycling had a significant effect on the change in micromotion between maximum and minimum loads at the anterior, medial, lateral, posteromedial, and posterolateral tray edge locations. A significant effect of fixation technique was detected for the anterior (P < .001), medial (P = .002), and lateral (P = .0056) locations but not for the posteromedial (P = .36) or posterolateral (P = .82) locations. Differences in micromotion between cemented and cementless components did not exceed 150 μm at any tested location.
Conclusion: The micromotion experienced by cementless tibial components in the present study may indicate a lower initial mechanical stability than the cemented group. However, this difference in initial stability may be subclinical because the differences between average cemented and cementless micromotion were <150 μm at all measured locations under the loading regime implemented.
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http://dx.doi.org/10.1016/j.arth.2017.03.039 | DOI Listing |
J Exp Orthop
January 2025
Department of Orthopaedic Surgery and Traumatology Città della Salute e della Scienza Turin Italy.
Purpose: This systematic review and meta-analysis aimed to compare the clinical and radiological outcomes of patients undergoing revision total knee arthroplasty (rTKA) using uncemented press-fit stems (hybrid fixation) versus cemented stems (cemented fixation). It is also examined whether cemented fixation offers any superiority over hybrid fixation regarding implant survival, clinical function, imaging analysis and complication rates.
Methods: Following the PRISMA guidelines, a systematic review and meta-analysis were conducted on five databases (Pubmed, Scopus, Embase, Medline and Cochrane).
Shoulder Elbow
January 2025
Orthopaedic and Trauma Surgery Department, Hospital de Terrassa, Terrassa, Barcelona, Spain.
Objectives: To evaluate the clinical significance of stress shielding in patients who have undergone an uncemented reverse shoulder arthroplasty (RSA) with a proximally coated stem for complex proximal humeral fractures (PHF) comprising 3 or 4 parts, assessed at 2 years postoperatively. Additionally, this study aims to examine the correlation between tuberosity healing and clinical outcomes.
Methods: Single Centre.
J Shoulder Elbow Surg
January 2025
Department of Orthopedic Surgery, Auckland City Hospital, Grafton, Auckland, New Zealand.
Hypothesis And Background: As the incidence of reverse total shoulder arthroplasty (RTSA) continues to rise, better understanding of the long-term risks and complications is necessary to determine the best choice of implant. The majority (75%) of RTSA performed in New Zealand use either SMR (Systema Multiplana Randelli, Lima-LTO, Italy) or Delta Xtend (DePuy Synthes, USA). The aim of this registry-based study was to compare implant survival, risk of revision and reasons for revision between the two most frequently used RTSA prostheses: SMR and Delta Xtend.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Faculty of Medicine, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria.
Orthop Traumatol Surg Res
December 2024
Société Française de Chirurgie Orthopédique et Traumatologique, 56 rue Boissonade, 75014 Paris Cedex, France.
Introduction: Lower limb length discrepancy (LLD) following hip arthroplasty after proximal femoral fracture (PFFA) is little studied. The aim of this work was to answer the following questions: 1) What are the incidence and mean values of LLD after PFFA? 2) What are the clinical consequences (tolerance) of LLD after PFFA? 3) Can we identify risk factors for LLD after PFFA? 4) Is there a significant difference in terms of LLD after PFFA to treat intra- versus extra-capsular fractures?
Hypothesis: LLD after proximal femoral fracture arthroplasty is rare but has good clinical tolerance, given the low functional demands of the patients.
Patients And Methods: This is a multicenter prospective observational cohort study (15 centers), including 590 patients, operated on for hip arthroplasty for proximal femur fracture between May 2022 and June 2023.
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