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Evaluating factors affecting patellar component fixation strength in total knee arthroplasty
Russell A Wagner1, Nathan E Lesley, René E Coté
1Program Director and Vice Chairman of Orthopaedic Residency, Department of Orthopaedic Surgery, John Peter Smith Hospital, Fort Worth, Texas; and Associate Professor, University of North Texas Health Science Center, Fort Worth. rwagner@jpshealth.org.
American Journal of Orthopedics (Belle Mead, N.J.)
|October 1, 2013
Summary
Allowing cement to cure before patellar component fixation in total knee arthroplasty (TKA) improves shear strength. Excessive pressure during implantation, however, can weaken patellar component fixation.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Biomechanics
Background:
- Patellofemoral joint complications are a leading cause of total knee arthroplasty (TKA) reoperations.
- Shear forces can lead to wear and fixation failure of all-polyethylene patellar components.
Purpose of the Study:
- To investigate the impact of cement curing time and applied pressure on patellar component fixation strength.
- To optimize surgical techniques for improved TKA outcomes.
Main Methods:
- Fifty-four cadaveric patellae were prepared for TKA.
- Cement curing time (2 vs. 8 minutes) and implantation pressure (42 vs. 62 pounds) were varied.
- Fixation strength was tested using a materials testing machine.
Main Results:
- Fixation strength was significantly higher when cement cured for 8 minutes compared to 2 minutes (P = .006).
- Fixation strength was significantly higher at 42 pounds of pressure compared to 62 pounds after 2 minutes of curing (P = .005).
Conclusions:
- Allowing cement to set during femoral and tibial component implantation does not compromise patellar component fixation.
- Excessive compression during patellar component implantation may weaken fixation strength.