Axial and Sagittal Rotation of Cementless Tibial Baseplates Occurs in Bone Under Joint Loading |
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| Institution: | 1. Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada;2. Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada;3. Imaging Group, Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada;1. Department of Orthopaedic Surgery, ENDO-Klinik Hamburg, Hamburg, Germany;2. Department of Orthopaedic Surgery and Traumatology, Centro Hospitalar Universitário do Porto, Porto, Portugal;1. Coxa Hospital for Joint Replacement, and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland;2. Department of Internal Medicine, Tampere University Hospital, Tampere, Finland;1. Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio;2. Department of Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina;3. Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina;4. Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland;1. Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas;2. Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana;1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota;2. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota |
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| Abstract: | BackgroundThere has been a recent increase in the use of cementless fixation for primary total knee arthroplasty. While the early results of contemporary cementless implants are promising, understanding the behavior of cementless tibial baseplates under loading remains an ongoing interest. The objective of this study was to identify the pattern of displacement that occurred under loading for a single cementless tibial baseplate design at one year post operation for stable and continuously migrating implants.MethodsThere were 28 subjects from a previous trial of a pegged highly porous cementless tibial baseplate evaluated. Subjects underwent supine radiostereometric exams from two weeks through one year after surgery. At one year, subjects also underwent a standing radiostereometric exam. Fictive points on the tibial baseplate model were used to relate translations to anatomical locations. Migration over time was calculated to determine if subjects displayed stable or continuous migration. The magnitude of inducible displacement between the supine and standing exams was calculated.ResultsInducible displacement patterns were similar between stable and continuously migrating tibial baseplates. Displacements were greatest in the anterior-posterior axis followed by the lateral-medial axis. Correlation of displacements between adjacent fictive points in these axes indicated an axial rotation of the baseplate occurred under loading (r2 = 0.689-0.977, P < .001). Less displacement occurred in the superior-inferior axis and correlations indicated an anterior-posterior tilt of the baseplate occurred under loading (r2 = 0.178-0.226, P = .009-.023).DiscussionFrom supine to standing position the predominant pattern of displacement for this cementless tibial baseplate was axial rotation, with some subjects also displaying an anterior-posterior tilt. |
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| Keywords: | total knee arthroplasty tibial baseplate cementless fixation radiostereometric analysis inducible displacement |
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