Bilateral tibial components of different cementless designs and materials. Microradiographic, backscattered imaging, and histologic analysis.
Postmortem evaluation was conducted on two cementless knee prostheses considered clinically successful. The two retrieved uncemented porous-coated tibial components of different designs, and materials were evaluated by microradiography, backscattered electron (BSE) imaging, and light microscopy. The right prosthesis, in place for 25 months, was a Porous-Coated Anatomic (PCA) implant with double-layered, sintered, cobalt-chromium alloy beads. The left prosthesis was a Natural-Knee (N-K) implant with a porous coating of cancellous-structured pure titanium implanted for 19 months. A quantitative microradiographic index, the appositional bone index (ABI), was developed to indicate the probability of bone ingrowth occurring into the porous coating. The ABI is a ratio of bone in apposition with porous coating divided by the total amount of porous coating available. The PCA had an average ABI of 9%, and the N-K, 67%. BSE images of the PCA demonstrated no bone within the porous coating. BSE images of the N-K implant showed bone ingrowth into 22% of the pore volume when porous coating was in apposition to host bone. Histology of the PCA revealed fibrous connective tissue throughout the porous coating and between the porous coating-bone interface. Histology of the N-K implant revealed bone ingrowth and osteoblastic activity along the bone within the porous coating.
Bloebaum
R D
RD
Department of Veterans Affairs Medical Center, Bone and Joint Research Laboratory, Salt Lake City, Utah 84148.
Rhodes
D M
DM
Rubman
M H
MH
Hofmann
A A
AA
D000368:Aged; D001842:Bone and Bones / Q000648:ultrastructure; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D007720:Knee Prosthesis; D008297:Male; D008852:Microradiography; D008855:Microscopy, Electron, Scanning / Q000379:methods; D016062:Porosity; D011474:Prosthesis Design