Primary stability of unicompartmental knee arthroplasty under dynamic flexion movement in human femora
Background: The objective of our study was to evaluate the impact of a trabecular stem fixation versus a cortical teeth fixation technique on the primary stability of cemented unicompartmental femoral components under dynamic flexion movement loading conditions in human femora. Methods: Ten fresh-frozen human knees of a mean donor age of 73.9years were used to perform medial unicompartmental knee arthroplasty under a less invasive parapatellar surgical approach. The femora were divided into two groups of matched pairs based on comparable trabecular bone mineral density. To assess the primary stability, a new method based on a combination of dynamic flexion movement, double-peak loading simulating stair climbing, kinematic analysis of the femoral component migration relative to the bone and an evaluation of the cement layer by fragments cut through the implant-cement-bone interface in the sagittal plane of the medial condyle was introduced. Findings: For the ''trabecular stem fixation'' technique the mean load to failure was 2340 (SD 650) N and for ''cortical teeth fixation'' it was 1080 (SD 455) N, with a substantially enhanced dynamic fixation strength for the ''trabecular stem fixation'' (p=0.008). In the distal area the cement layer of the ''trabecular stem fixation'' showed a significant decreased thickness compared to the ''cortical teeth fixation'' (p=0.029), while a substantially deeper cement penetration (p=0.044) has been achieved for the ''trabecular stem fixation''. Interpretation: From our observations, we conclude that there is a significantly enhanced primary stability with a ''trabecular stem fixation'' compared to a ''cortical teeth fixation'' technique of cemented unicompartmental femoral components, in terms of dynamic failure load and migration characteristics.
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- DOI : http://dx.doi.org/10.1016/j.clinbiomech.2016.11.006
- Elsevier : 저널> 권호 > 논문
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