Evaluation of tibial component fixation in specimens retrieved at autopsy

Fixation of the tibial component was evaluated in eight knees retrieved at autopsy by comparing their radiographs with measurements of micromovement between the component and the tibial plateau. Micromovement in the one cemented Miller-Galante and seven cementless Ortholoc components, which had been implanted for a range of 3 days to 57 months, was measured with linearly variable differential transducers under anteroposterior shear and axial compressive loads. Micromovement between the tibial component and the screws and between the tibial component and the bone after the screws were removed also was measured in the cementless specimens. Minimal micromovement in most of the implants suggests that the tibial components were well fixed. Micromovement between the tibial tray and the screws also was minimal in the cementless components. Removing the screws did not significantly affect micromovement, except in the specimen retrieved 3 days after surgery and in the specimen with a complete radiolucent line under the component. The cementless tibial components fixed with screws, pegs, and stem were as stable as the component secured with cement. Partial radiolucencies were not associated with greater micromotion than that of bone ingrown areas, but the component with complete radiolucency did have greater micromotion than that of all of the other specimens.