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- W2979924369 abstract "Abstract Background Cementless TKA has been developed to decrease the incidence of failure in younger and more active patients. However, failures of cementless components are still more common. It is hypothesized that this is triggered by incomplete bony-tray contact. The present study compares the final seated contact area of a cementless tray as a function of the initial osteotomy flatness. Method Eight surgeons prepared 14 cadaveric knees for cementless TKR using standard instrumentation. The topography of each osteotomy was captured with a laser scanner, 3D computer models of the surfaces were generated. After scanning, cementless tibial trays were implanted using a manual impactor. Each tibia was then dissected, embedded in mounting resin, and sectioned. The sectioned blocks were observed under stereomicroscopy to identify points of bone-tray contact and incorporated into the 3D models. Maps were then generated to determine contacting and non-contacting areas. Results The mean initial flatness for all specimens was 1.1±0.35mm. After impaction, 79.4±0.3% of the surface had establish contact. Of the non-contacting areas, 17.6% was within 0.3mm of the tray. Only 2.6% of the surface were at distances reported to impede ingrowth. Non-contacting areas were typically located centrally. A trend of decreasing percent contact area with increased flatness tolerance was observed (R2=0.605). Conclusions i. There is an inverse correlation between the flatness of the tibial osteotomy and the percentage of the bony surface in contact with underside of the tibial tray.ii. Almost all tray-tibia contact is generated during implantation through flattening of elevated features on the tibial surface.iii. Gaps between the tray and the tibia are consistently located in the central regions of the osteotomy proximal to the medullary canal." @default.
- W2979924369 created "2019-10-18" @default.
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- W2979924369 date "2020-03-01" @default.
- W2979924369 modified "2023-09-27" @default.
- W2979924369 title "How Flat Is the Tibial Osteotomy in Total Knee Arthroplasty?" @default.
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- W2979924369 doi "https://doi.org/10.1016/j.arth.2019.10.007" @default.
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