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Initial stability of a new cementless fixation method of a tibial component with polyaxial locking screws: a biomechanical in vitro examination

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Cementless fixation of the tibial component is critical as reduced initial stability leads to implant failure. In this experimental in vitro study, a new fixation method of the tibial component using polyaxial locking screws is evaluated using Roentgen stereophotogrammetric analysis (RSA).

Materials and Methods

A special prototype of a tibial component with four polyaxial locking screws was tested on 10 fresh-frozen human tibia specimens. The components were tested with an axial load of 2000 N for 10,000 cycles. Radiographs in two views were performed before loading, after 1000 and after 10,000 cycles, respectively. Besides rotation and translation along the x-, y-, and z-axes, endpoints for RSA were maximum subsidence (MaxSub), maximum lift off (MaxLiftOff) and maximum total point motion (MTPM).

Results

MaxSub increased from −0.5 mm (SD = 0.2) after 1000 cycles to −0.9 mm (SD = 1.1). MaxLiftOff was 0.1 mm after 1000 cycles and did not increase after 10,000 cycles. The MTPM was 0.7 mm (SD = 0.3) after 1000 cycles and 1.1 mm (SD = 1.1) after 10,000 cycles. Two out of nine implants showed an MTPM ≥ 1.0 mm after 10,000 cycles.

Conclusions

Polyaxial locking screws can potentially improve the initial stability of tibial components. The results of this study indicate that the use of such screws in total knee arthroplasty may be of interest in the future. Further experimental and clinical investigation is needed.

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Acknowledgments

The authors want to thank the Anatomical Institute of the University of Düsseldorf for donating the tibia specimen. Furthermore, we thank our biomechanical engineers for constructing the prototype used in this study

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    Authors and Affiliations

    1. Center of Orthopaedics and Trauma Surgery, University Hospital Marburg, Baldingerstraße, 35043, Marburg, Germany

      Christian Benzing, Adrian Skwara & Jürgen Paletta

    2. Group Practice Borken, Duesberg Str. 1, 46325, Borken, Germany

      Adrian Skwara

    3. Department of Diagnostic Radiology, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany

      Jens Figiel

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    1. Christian Benzing
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    2. Adrian Skwara
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    Correspondence to Jürgen Paletta.

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    C. Benzing and A. Skwara contributed equally.

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    Benzing, C., Skwara, A., Figiel, J. et al. Initial stability of a new cementless fixation method of a tibial component with polyaxial locking screws: a biomechanical in vitro examination. Arch Orthop Trauma Surg 136, 1309–1316 (2016). https://doi.org/10.1007/s00402-016-2517-6

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    • DOI: https://doi.org/10.1007/s00402-016-2517-6

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