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Micromotion and Migration of Cementless Tibial Trays Under Functional Loading Conditions.
Han, Shuyang; Patel, Rikin V; Ismaily, Sabir K; Jones, Hugh L; Gold, Jonathan E; Noble, Philip C.
Afiliación
  • Han S; Institute of Orthopedic Research and Education, Houston, Texas; Department of Orthopedic Surgery, McGovern Medical School, UTHealth, Houston, Texas.
  • Patel RV; Institute of Orthopedic Research and Education, Houston, Texas.
  • Ismaily SK; Institute of Orthopedic Research and Education, Houston, Texas; Department of Orthopedic Surgery, McGovern Medical School, UTHealth, Houston, Texas.
  • Jones HL; Institute of Orthopedic Research and Education, Houston, Texas; Department of Orthopedic Surgery, McGovern Medical School, UTHealth, Houston, Texas.
  • Gold JE; Institute of Orthopedic Research and Education, Houston, Texas; Department of Orthopedic Surgery, McGovern Medical School, UTHealth, Houston, Texas.
  • Noble PC; Institute of Orthopedic Research and Education, Houston, Texas; Department of Orthopedic Surgery, McGovern Medical School, UTHealth, Houston, Texas.
J Arthroplasty ; 36(1): 349-355, 2021 01.
Article en En | MEDLINE | ID: mdl-32741712
BACKGROUND: The outcome of cementless total knee arthroplasty (TKA) relies on successful bony ingrowth into the implant surfaces. Failures due to aseptic loosening are still reported, especially in younger and more active patients. The objective of this study is to quantify the micromotion of a commercially available design of cementless tibial tray under loading conditions simulating walking and stair descent. METHOD: A commercially available design of cementless total knee arthroplasty was implanted in 7 cadaveric knees which were preconditioned with 500 cycles of 0°-100° flexion under a vertical load of 1050 N in a custom-built, multiaxial functional activity simulator. This was followed by application of the peak forces and moments occurring during walking and stair descent. During each loading procedure, 3-dimensional motion at the bone-prosthesis interface was measured using digital image correlation. RESULTS: The tray migrated 101 ± 25 µm on average during preconditioning, which was dominated by rotation in the sagittal plane (92% of total migration), combined with posterior translation (28%) and minimal rotation in the transverse plane (14%). The migration varied 2.7-fold (61-167 µm) between the 6 measurement zones. Stair descent produced significantly higher total micromotion than walking in zone #5 (62 ± 9 vs 51 ± 10 µm, P < .05) and zone #6 (68 ± 17 vs 37 ± 10 µm, P < .05). In addition, during stair descent, the tray exhibited significantly more tilting (anterior zones: 31 ± 17 vs -16 ± 20 µm, P < .05; posterior zones: -60 ± 8 vs -40 ± 7 µm, P < .05) and more anteroposterior displacement in the anterior zones (-25 ± 3 vs -13 ± 2 µm, P < .05) when compared to walking. CONCLUSION: The relative motion at the bone-prosthesis interface varied substantially around the periphery of the cementless tray. Under the loading conditions evaluated, the tray primarily underwent a rocking motion in the sagittal plane. Compared with walking, stair descent produced significantly more micromotion, especially in the posterior zones.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos