Bone bed preparation techniques will influence the cementation of total knee replacement: a cadaveric study
Refereed conference paper presented and published in conference proceedings
CUHK Authors
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AbstractIntroduction: Aseptic loosening after TKA remains the common reason for failure, and is the major cause of TKA revisions. Desirable fixation relies on the biomechanical properties of the bone-cement interface. More specifically, different osteotomy tools may produce bone surfaces with varying roughness and surface area.
Methods: Three paired commercially available fresh-frozen pelvis-to-toe cadavers were used. Standard TKA was performed on each pair of knees. On one side, bone preparation was performed using bone burr, and on the other side, the bone was cut using oscillating saw. Cementation pressure was standardised using Verasense (Orthosensor, USA). Maximum failure load was determined using a pull-out test with a cross-head speed increment of the material testing machine (Hounsfield H25K-S, Salfords, Redhill, United Kingdom). Computer tomography scans were performed for all the samples before the pull out test. The cement layer was segmented from the CT scans and analyzed using 3D slicer software.
Results: The average pull-out strength for the burr group (2230 N) exceeded the saw group (1760 N). Cement penetration was significantly higher in the burr group compared to the saw group (3.22±1.82 cm3 vs. 2.99±1.68 cm3 , p=0.0291).
Discussion and Conclusion: Bone preparation with the use of burr improves fixation strength and bone cement penetration when compared to conventional saw. Long term clinical studies are warranted to confirm whether the biomechanical advantage of burr bone preparation translates to superior implant survivorship.
Methods: Three paired commercially available fresh-frozen pelvis-to-toe cadavers were used. Standard TKA was performed on each pair of knees. On one side, bone preparation was performed using bone burr, and on the other side, the bone was cut using oscillating saw. Cementation pressure was standardised using Verasense (Orthosensor, USA). Maximum failure load was determined using a pull-out test with a cross-head speed increment of the material testing machine (Hounsfield H25K-S, Salfords, Redhill, United Kingdom). Computer tomography scans were performed for all the samples before the pull out test. The cement layer was segmented from the CT scans and analyzed using 3D slicer software.
Results: The average pull-out strength for the burr group (2230 N) exceeded the saw group (1760 N). Cement penetration was significantly higher in the burr group compared to the saw group (3.22±1.82 cm3 vs. 2.99±1.68 cm3 , p=0.0291).
Discussion and Conclusion: Bone preparation with the use of burr improves fixation strength and bone cement penetration when compared to conventional saw. Long term clinical studies are warranted to confirm whether the biomechanical advantage of burr bone preparation translates to superior implant survivorship.
All Author(s) ListJonathan Patrick Ng, Dennis King Hang Yee, Ming Qian Yu, Mingde Cao, Kevin Ki Wai Ho, James Griffith, Michael Tim Yun Ong, Patrick Shu Hang Yung
Name of ConferenceThe HKOA 43rd Annual Congress of The Hong Kong Orthopaedic Association
Start Date of Conference04/11/2023
End Date of Conference05/11/2023
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
Year2023
Month11
PublisherHong Kong Academy of Medicine Press
Place of PublicationHong Kong
Pages76 - 76
LanguagesEnglish-United States
