Comparative biomechanical in vitro study of different modular total knee arthroplasty revision stems with bone defects

Link:
Autor/in:
Verlag/Körperschaft:
Hamburg University of Technology
Erscheinungsjahr:
2020
Medientyp:
Text
Schlagworte:
  • bone defect
  • femoral component micromotion
  • femoral cone
  • primary stability
  • revision knee arthroplasty
  • stem length
  • 570: Biowissenschaften, Biologie
  • 600: Technik
  • 610: Medizin
Beschreibung:
  • © 2020 Elsevier Inc. Background: The aim of this study is to investigate the effects of different stem lengths and types including cones on primary stability in revision total knee arthroplasty with different femoral bone defects and fixation methods in order to maximize bone preservation. It is hypothesized that longer stems provide little additional mechanical stability. Methods: Thirty-five human femurs were investigated. A distal bone defect, Anderson Orthopedic Research Institute classification (s. 33) type-F2a, was created in group 1-3 and type-F3 in group 4-6. A cemented, rotating hinge femoral component was combined with different stems (100 and 160 mm total or hybrid cemented cones, or a 100-mm custom-made anatomical cone stem). The femora were loaded according to in vivo loading during gait. Relative movements were measured to investigate primary stability. Pull-out testing was used to obtain a parameter for the primary stability of the construct. Results: Relative movements were small and similar in all groups (<40 μm). For small defect, the pull-out forces of cemented long (4583 N) and short stems (4650 N) were similar and about twice as high as those of uncemented stems (2221 N). For large defects, short cemented stems with cones showed the highest pull-out forces (5500 N). Long uncemented stems (3324 N) and anatomical cone stems (3990 N) showed similar pull-out forces. Conclusion: All tested stems showed small relative movements. Long cemented stems show no advantages to short cemented stems in small bone defects. The use of cones or an anatomical cone stem with hybrid cementation seems to offer good stability even for larger bone defects. The use of a short cemented stem (with or without cone) may be a suitable choice with a high potential for bone preservation in total knee arthroplasty revision with respective bone defects.
Beziehungen:
DOI 10.1016/j.arth.2020.06.035
Quellsystem:
TUHH Open Research
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Quelldatensatz
oai:tore.tuhh.de:11420/7432