title: Use of bone compaction in total knee arthroplasty.
abstract: This study compared the effects of bone preparation on tibial stem stability in total knee arthroplasty. Six pairs of fresh-frozen tibias underwent implantation of an 18 x 75-mm press-fit stem (minus the tibial tray). The standard press-fit technique was performed creating a cavity 17 mm in diameter. For the bone compaction technique, stainless-steel dilators were machined ranging in diameter from 6 to 16 mm in 2-mm increments. The technique consisted of using the dilators and a mallet to create a compacted tunnel in a sequential manner to 16 mm in diameter followed by implantation of the stem. The specimens were mounted on a materials testing machine and loads were applied in both planes: anteroposterior and mediolateral. A preconditioning load of 100 N was applied followed by a second 100-N load from which the stiffness (N/mm) of implantation was calculated. The stability of the tibial stems implanted by compaction averaged 84.7% greater when compared with the press-fit stems (P < .017 by multivariate analysis).
authors.affiliation: Duke Orthopaedic Research Laboratory, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Channer
authors.forename: R R
authors.initials: RR
authors.lastname: Glisson
authors.forename: A V
authors.initials: AV
authors.lastname: Seaber
authors.forename: T P
authors.initials: TP
authors.lastname: Vail
mesh_terms: D001696:Biomechanical Phenomena; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008722:Methods; D008875:Middle Aged; D013977:Tibia / Q000502:physiology / Q000601:surgery