MICROMOTION SECONDARY TO AXIAL, TORSIONAL, AND SHEAR LOADS IN 2 MODELS OF CEMENTLESS TIBIAL COMPONENTS

被引:35
作者
KRAEMER, WJ [1 ]
HARRINGTON, IJ [1 ]
HEARN, TC [1 ]
机构
[1] TORONTO E GEN & ORTHOPAED HOSP,TORONTO,ON M4C 3E7,CANADA
关键词
MICROMOTION; KNEE ARTHROPLASTY; UNCEMENTED IMPLANTS; POROUS INGROWTH;
D O I
10.1016/S0883-5403(05)80132-9
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Tibial component loosening and lack of bone ingrowth remain serious problems in uncemented knee arthroplasty. Initial implant stability is the most important factor in achieving bone ingrowth. Eccentric axial loading causing liftoff has been identified as a potential problem, but the role of torsion and shear stability is unclear. This study assesses the micromotion in two uncemented components subjected to eccentric axial (lateral, medial, posterior, anterior), shear, and torsional loads. Four configurations were tested: Tricon M (pegs) (Smith and Nephew Richards, Memphis, TN), Genesis (stem only) (Smith and Nephew Richards), Genesis with screws, and Genesis with pegs. Nine pairs of cadaver tibias were implanted, and cyclic loads were applied. Micromotion was measured with two linear variable differential transformers. Micromotion values for each mode of loading were compared using a one-way analysis of variance. Genesis with screws had the least micromotion for all applied loads (14-33 mu m), whereas Genesis with stem only had the maximum value of micromotion (27-212 mu m). Genesis with pegs and Tricon had intermediate ranges of micromotion (32-121 and 107-140 mu m, respectively). It is concluded that peg fixation and stem fixation are inadequate and result in significant micromotion. Stem plus screws provides the most stable fixation and may be compatible with bone ingrowth.
引用
收藏
页码:227 / 235
页数:9
相关论文
共 19 条
[11]  
Schneider, Michel, Genge, Wyder, In vivo load measurements by means of an instrumented interlocking nail, Proceedings of the 7th meeting of the European Society of Biomechanics, (1990)
[12]  
Thatcher, Zhou, Walker, Inherent laxity in total knee prostheses, J Arthroplasty, 2, (1987)
[13]  
Kaiser, Whiteside, The effect of screws and pegs on the initial fixation stability of an uncemented unicondylar knee replacement, Clin Orthop Relat Res, 259, (1990)
[14]  
Miura, Whiteside, Easley, Amador, Effects of screws and a sleeve on the initial fixation in uncemented total knee tibial components, Clin Orthop Relat Res, 259, (1990)
[15]  
Walker, Hsu, Zimmerman, A comparative study of uncemented tibial components, J Arthroplasty, 5, (1990)
[16]  
Black, Orthopaedic biomaterials in research and practice, (1988)
[17]  
Branson, Steege, Wixson, Et al., Rigidity of initial fixation with uncemented tibial knee implants, J Arthroplasty, 4, (1989)
[18]  
Finlay, Bourne, Kraemer, Et al., Stiffness of bone underlying the tibial plateaus of osteoarthritic and normal knees, Clin Orthop Relat Res, 247, (1989)
[19]  
Kraemer, Bourne, Finlay, Andreae, Cancellous bone properties of osteoarthritic and normal tibial plateaus, Transactions of the 34th annual meeting of the Orthopaedic Research Society, 13, (1988)