Case series report: Early cement–implant interface fixation failure in total knee replacement

Abstract Background Early failure in cemented total knee replacement (TKR) due to aseptic loosening is uncommon. A small number of early failures requiring revision were observed at one hospital due to observed cement–implant fixation failure. The purpose of this case series is to report and identif...

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Bibliographic Details
Published in:The knee 2015-10, Vol.22 (5), p.424-428
Main Authors: Hazelwood, Kyle J, O’Rourke, Michael, Stamos, Van P, McMillan, Robert D, Beigler, David, Robb, William J
Format: Article
Language:English
Subjects:
Aged
Arthroplasty, Replacement, Knee
Aseptic loosening
Bone Cements
Cement
Cement–implant interface
Conflicts of interest
Early aseptic total knee failure
Failure
Female
High-viscosity cement
Hospitals
Humans
Knee
Knee Prosthesis - adverse effects
Male
Middle Aged
Orthopedics
Patient satisfaction
Patients
Polymerization
Primary total knee arthroplasty
Prosthesis Failure
Reoperation
Retrospective Studies
Surgical outcomes
Surgical techniques
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Summary:Abstract Background Early failure in cemented total knee replacement (TKR) due to aseptic loosening is uncommon. A small number of early failures requiring revision were observed at one hospital due to observed cement–implant fixation failure. The purpose of this case series is to report and identify possible causes for these early failures. Methods Between May 2005 and December 2010, 3048 primary TKRs were performed over a five-year period of time by six surgeons. Two total knee systems were used during this period of time. Nine early failures were observed in eight patients. High viscosity cement (HVC) was used in all these cases. Results Aseptic loosening of the tibial component was observed in all nine early total knee failures. The high viscosity bone cement was noted to be non-adherent to the tibial trays at the time of revision surgery. HVC was used in all these cases. Conclusions Properties of HVC may contribute to make it more susceptible to early failure in a small number of TKRs. HVC in total hip replacement (THR) has been associated with cement micro-fractures, cement debris generation and early implant failure. The mechanical properties of HVC may similarly contribute to early failure at the cement–implant interface in a small percentage TKRs.
ISSN:0968-0160
1873-5800
DOI:10.1016/j.knee.2015.02.016