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Primary Stability in Cementless Rotating Platform Total Knee Arthroplasty.

Scott R Small1, Renee D Rogge2, Eric M Reyes3

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Summary

This study assessed cementless total knee arthroplasty tibial tray stability with porous ingrowth surfaces. No significant difference in primary stability was found between sintered bead and roughened porous coatings.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering
  • Biomechanics

Background:

  • Cementless total knee arthroplasty (TKA) relies on porous ingrowth surfaces for long-term tibial component fixation.
  • Improving primary stability is crucial for enhancing survivorship and preventing early loosening.

Purpose of the Study:

  • To evaluate the impact of different porous ingrowth surface designs on the primary stability of cementless tibial trays.
  • To compare the mechanical performance of sintered bead versus roughened porous coatings.

Main Methods:

  • Three tibial tray designs with sintered bead or roughened porous coatings were tested.
  • Primary stability was assessed using digital image correlation in foam tibia models during simulated stair descent and condylar liftoff.
  • Cadaveric tibias were used for follow-up testing to evaluate micromotion under condylar liftoff loading.

Main Results:

  • The sintered bead tibial tray showed slightly lower micromotion than the roughened porous coating during stair descent loading.
  • No significant differences in primary stability were detected between the ingrowth surface designs in either foam or cadaveric models.
  • Cementless tibial trays demonstrated good stability (<80 microns micromotion, 1 mm subsidence) under cyclic loading.

Conclusions:

  • While porous ingrowth surfaces are vital for biological fixation and osteointegration, this study did not find significant differences in primary stability between the tested surface designs.
  • The findings suggest that current iterations of porous ingrowth surface designs provide comparable primary stability in cementless tibial components.