Tibial component fixation in porous- and hydroxyapatite-coated total knee arthroplasty: a radiostereo metric evaluation of migration and inducible displacement after 5 years.

A total of 51 knees (45 patients) with osteoarthrosis were stratified in a randomized study to receive a hydroxyapatite-coated Freeman-Samuelson (FS HA) or a porous-coated Miller-Galante II (MG II) uncemented total knee arthroplasty. Repeated clinical, radiographic, and radiostereometric analysis (RSA) evaluations of the tibial components were done for 5 years. The clinical outcome was equal at the 5-year follow-up (mean Hospital for Special Surgery score, 93). Standard radiographs displayed more zones around the tibial stem in the MG II group. RSA revealed that the FS HA components migrated less (smaller maximum total point motion and maximum subsidence) after 5 years and showed less inducible displacements at the 1-year follow-up. The stability of the implants obtained is equal to or better than cemented implants after 5 years. Key words: knee prosthesis, cementless, hydroxyapatite, radiostereometry, inducible displacement.

[1]  J Kärrholm,et al.  Hydroxyapatite coating versus cemented fixation of the tibial component in total knee arthroplasty: prospective randomized comparison of hydroxyapatite-coated and cemented tibial components with 5-year follow-up using radiostereometry. , 1999, The Journal of arthroplasty.

[2]  P. Herberts,et al.  Ceramic coating improves tibial component fixation in total knee arthroplasty. , 1998, The Journal of arthroplasty.

[3]  S. Shott,et al.  Hydroxyapatite augmentation of the porous coating improves fixation of tibial components. A randomised RSA study in 116 patients. , 1998, The Journal of bone and joint surgery. British volume.

[4]  P. Herberts,et al.  Clinical and radiologic survivorship of cementless tibial components fixed with finned polyethylene pegs. , 1997, The Journal of arthroplasty.

[5]  L R Jordan,et al.  Survivorship analysis of cementless meniscal bearing total knee arthroplasty. , 1997, Clinical orthopaedics and related research.

[6]  C. Bünger,et al.  Role of different loading conditions on resorption of hydroxyapatite coating evaluated by histomorphometric and stereological methods , 1996, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[7]  T. Koshino,et al.  Pain reduction after anteromedial displacement of the tibial tuberosity: 5-year follow-up in 21 knees with patellofomoral arthrosis. , 1996, Acta orthopaedica Scandinavica.

[8]  S. Toksvig-Larsen,et al.  The Porous-Coated Anatomic total knee experience. Special emphasis on complications and wear. , 1996, The Journal of arthroplasty.

[9]  J Kärrholm,et al.  RSA in the assessment of aseptic loosening. , 1996, The Journal of bone and joint surgery. British volume.

[10]  R. Bourne,et al.  Screw Osteolysis After Cementless Total Knee Replacement , 1995, Clinical orthopaedics and related research.

[11]  L. Whiteside.  Effect of Porous‐Coating Configuration on Tibial Osteolysis After Total Knee Arthroplasty , 1995, Clinical orthopaedics and related research.

[12]  R. Geesink,et al.  Six-year results of hydroxyapatite-coated total hip replacement. , 1995, The Journal of bone and joint surgery. British volume.

[13]  P. Buma,et al.  Tissue reactions around a hydroxyapatite-coated hip prosthesis. Case report of a retrieved specimen. , 1995, The Journal of arthroplasty.

[14]  S. Toksvig-Larsen,et al.  Roentgen stereophotogrammetric analysis as a predictor of mechanical loosening of knee prostheses. , 1995, The Journal of bone and joint surgery. British volume.

[15]  J. Galante,et al.  Bone ingrowth and wear debris in well-fixed cementless porous-coated tibial components removed from patients. , 1995, The Journal of arthroplasty.

[16]  L Ryd,et al.  The stability of three different cementless tibial components. A randomized radiostereometric study in 45 knee arthroplasty patients. , 1995, Acta orthopaedica Scandinavica.

[17]  P. Herberts,et al.  Bone response to hydroxyapatite‐coated and commercially pure titanium implants in the human arthritic knee , 1994, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[18]  M. Gottlander.  On hard tissue reactions to hydroxyapatite-coated titanium implants , 1994 .

[19]  L. Whiteside,et al.  Cementless total knee replacement , 1994 .

[20]  L. Dorr,et al.  Complications with hydroxyapatite particulate separation in total hip arthroplasty. , 1994, Clinical orthopaedics and related research.

[21]  J. Kärrholm,et al.  Increased varus-valgus tilting of screw-fixated knee prostheses. Stereoradiographic study of uncemented versus cemented tibial components. , 1993, The Journal of arthroplasty.

[22]  L Ryd,et al.  Micromotion of a noncemented tibial component with screw fixation. An in vivo roentgen stereophotogrammetric study of the Miller-Galante prosthesis. , 1993, Clinical orthopaedics and related research.

[23]  R. E. Jensen,et al.  Loss of hydroxyapatite coating on retrieved, total hip components. , 1993, The Journal of arthroplasty.

[24]  A. Nachemson.  Low-back pain. Are orthopedic surgeons missing the boat? , 1993, Acta orthopaedica Scandinavica.

[25]  K. Søballe,et al.  Hydroxyapatite ceramic coating for bone implant fixation. Mechanical and histological studies in dogs. , 1993, Acta orthopaedica Scandinavica. Supplementum.

[26]  R. Bloebaum,et al.  Bone ingrowth into porous-coated tibial components implanted with autograft bone chips. Analysis of ten consecutively retrieved implants. , 1992, The Journal of arthroplasty.

[27]  G. Engh,et al.  Osteolysis after total knee arthroplasty without cement. , 1992, The Journal of bone and joint surgery. American volume.

[28]  G. Engh,et al.  Polyethylene wear of metal-backed tibial components in total and unicompartmental knee prostheses. , 1992, The Journal of bone and joint surgery. British volume.

[29]  M. Freeman,et al.  The effect of hydroxyapatite coating on ingrowth of bone into cavities in an implant. , 1991, The Journal of arthroplasty.

[30]  L Ryd,et al.  Surface flatness after bone cutting. A cadaver study of tibial condyles. , 1991, Acta orthopaedica Scandinavica.

[31]  L. Whiteside,et al.  Effects of screws and a sleeve on initial fixation in uncemented total knee tibial components. , 1990, Clinical orthopaedics and related research.

[32]  F. C. Ewald.  The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. , 1989, Clinical orthopaedics and related research.

[33]  J Kärrholm,et al.  Roentgen stereophotogrammetry. Review of orthopedic applications. , 1989, Acta orthopaedica Scandinavica.

[34]  L. Carlsson.  On the development of a new concept for orthopaedic implant fixation , 1989 .

[35]  P. Herberts,et al.  ICLH knee arthroplasty , 1988 .

[36]  R. Volz,et al.  The mechanical stability of various noncemented tibial components. , 1988, Clinical orthopaedics and related research.

[37]  P S Walker,et al.  Inherent laxity in total knee prostheses. , 1987, The Journal of arthroplasty.

[38]  G Markhede,et al.  Extra-abdominal desmoid tumors. , 1986, Acta orthopaedica Scandinavica.

[39]  L Ryd,et al.  Micromotion in knee arthroplasty. A roentgen stereophotogrammetric analysis of tibial component fixation. , 1986, Acta orthopaedica Scandinavica. Supplementum.

[40]  M. Freeman,et al.  Freeman-Samuelson total arthroplasty of the knee. , 1985, Clinical orthopaedics and related research.

[41]  S. Pocock,et al.  Clinical Trials: A Practical Approach , 1984 .

[42]  K. Markolf,et al.  The role of joint load in knee stability. , 1981, The Journal of bone and joint surgery. American volume.

[43]  S. Ahlback,et al.  Osteoarthrosis of the knee. A radiographic investigation. , 1968 .