Equivalent 2-year stabilization of uncemented tibial component migration despite higher early migration compared with cemented fixation: an RSA study on 360 total knee arthroplasties

Authors

  • Elise K Laende School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada; Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
  • Janie L Astephen Wilson School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
  • Joanna Mills Flemming Department of Mathematics and Statistics, Dalhousie University, Halifax, Nova Scotia, Canada
  • Edward R Valstar Department of Orthopedics, Leiden University Medical Center, Leiden, The Netherlands
  • C Glen Richardson Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
  • Michael J Dunbar School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada; Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada

DOI:

https://doi.org/10.1080/17453674.2018.1562633

Abstract

Background and purpose — Thresholds of implant migration for predicting long-term successful fixation of tibial components in total knee arthroplasty have not separated cemented and uncemented fixation. We compared implant migration of cemented and uncemented components at 1 year and as the change in migration from 1 to 2 years.

Patients and methods — Implant migration of 360 tibial components measured using radiostereometric analysis was compared at 1 year and as the change in migration from 1 to 2 years in 222 cemented components (3 implant designs) and 138 uncemented components (5 implant designs).

Results — 1-year maximum total point motion was lower for the cemented tibial components compared with the uncemented components (median = 0.31 mm [0.03–2.98] versus 0.63 mm [0.11–5.19] respectively, p < 0.001, mixed model). The change in migration from 1 to 2 years, however, was equivalent for cemented and uncemented components (mean [SD] 0.06 mm [0.19] and 0.07 mm [0.27] mm respectively, p = 0.6, mixed model).

Interpretation — These findings suggest that current thresholds of acceptable migration at 1 year may be better optimized by considering cemented and uncemented tibial components separately as higher early migration of uncemented components was not associated with decreased stability from 1 to 2 years.

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Published

2019-01-23

How to Cite

Laende, E. K., Astephen Wilson, J. L. ., Mills Flemming, J. ., Valstar, E. R., Richardson, C. G., & Dunbar, M. J. (2019). Equivalent 2-year stabilization of uncemented tibial component migration despite higher early migration compared with cemented fixation: an RSA study on 360 total knee arthroplasties. Acta Orthopaedica, 90(2), 172–178. https://doi.org/10.1080/17453674.2018.1562633