Tibial component with and without stem extension in a trabecular metal cone construct
Publication year
2017Source
Knee Surgery, Sports Traumatology, Arthroscopy, 25, 11, (2017), pp. 3644-3652ISSN
Publication type
Article / Letter to editor
Display more detailsDisplay less details
Organization
Orthopaedics
Journal title
Knee Surgery, Sports Traumatology, Arthroscopy
Volume
vol. 25
Issue
iss. 11
Page start
p. 3644
Page end
p. 3652
Subject
Radboudumc 10: Reconstructive and regenerative medicine RIHS: Radboud Institute for Health Sciences; Orthopaedics - Radboud University Medical CenterAbstract
PURPOSE: The purpose of this study was to investigate stability and strain distribution of a tibial plateau reconstruction with a trabecular metal cone while the tibial component is implanted with and without a stem, and whether prosthetic stability was influenced by bone mineral density. Trabecular metal cones are designed to fill up major bone defects in total knee arthroplasty. Tibial components can be implanted in combination with a stem, but it is unclear whether this is necessary after reconstruction with a trabecular metal cone. Implanting a stem can give extra stability, but may have negative side effects. METHODS: Tibial revision arthroplasties with trabecular metal cones were performed after reconstruction of a 2B bone defect according to the Anderson Orthopedic Research Institute classification. Components were implanted in seven pairs of cadaveric tibiae; one tibia of each pair was implanted with stem and the other without. All specimens were loaded to one bodyweight alternating between the medial and lateral tibial component. Implant-bone micro-motions, bone strains, bone mineral density and correlations were measured and/or calculated. RESULTS: Tibial components without a stem showed only more varus tilt [difference in median 0.14 degrees (P < 0.05)], but this was not considered clinically relevant. Strain distribution did not differ. Bone mineral density only had an effect on the anterior/posterior tilt [rho: -0.72 (P < 0.01)]. CONCLUSION: Tibial components, with or without a stem, which are implanted after reconstruction of major bone defects using trabecular metal cones produce very similar biomechanical conditions in terms of stability and strain distribution. If in vivo studies confirm that a stem extension is not mandatory, orthopaedic surgeons can decide not to implant a stem. LEVEL OF EVIDENCE: II.
This item appears in the following Collection(s)
- Academic publications [246515]
- Electronic publications [134102]
- Faculty of Medical Sciences [93308]
- Open Access publications [107633]
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.