Abstract
Aseptic loosening of the tibial component continues to be a significant mode of failure
in total knee arthroplasty surgery. Surface cemented components preserve tibial bone
stock, but are reliant on a strong bone–cement interface. This study compares standard
surface cemented tibial component design to a tibial component with the addition of
an undersurface cement containment skirt. The hypothesis was that the addition of
a 2-mm underside skirt would allow cement containment and pressurization during implantation,
which might improve the overall survival. Two identical tibial components were used,
out of which one had the 2-mm underside skirt removed for the purposes of this study.
Overall, 12 tibial Sawbones were prepared identically and transducers placed in the
medial and lateral plateau. Each component was implanted six times, according to the
manufacturer's operative technique. The series of implantation experiments showed
no difference in cement pressurization (p = 0.86) regardless of the tibial component design used, with a wide variation in
pressure measurements occurring in both groups. The tibial component skirt has not
demonstrated any enhancement in cement pressurization. The cement containment skirt
might still be advantageous by increasing the cement mantle thickness without causing
excessive bone penetration; however, the biological effects cannot be predicted without
further clinical evaluation.
Keywords
cement - knee - pressurization
