[Cemented total knee arthroplasties].
BACKGROUND
The aseptic loosening of cemented total knee arthroplasties is still an unsolved problem. In this regard, the hydrolysis resistance in the metal-to-bone cement interface is of major importance.


METHODS
Cemented pre-treated tibia components coated by means of a silica/silane interlayer system of the model "Columbus PS" were dynamically loaded with the help of a knee-simulator similar to DIN ISO 14243. After loading, the components were microscopically analysed concerning debonding in the metal-to-bone cement interface as well as with regard to cement mantle defects. These data were matched with uncoated "Columbus PS" components. Unloaded coated and uncoated tibia components acted as a control.


RESULTS
In comparison with uncoated tibia components, the pre-treated and coated ones yielded a highly significant reduction of cement defects (p < 0.01) as well as a significant reduction of debonding in the metal-to-bone cement interface (p < 0.05).


CONCLUSIONS
By means of the silica/silane interlayer system for cemented tibia components, a hydrolytic debonding in the metal-to-bone cement interface with subsequent mechanical loosening and consecutive early cement mantle failure can be significantly reduced. This could lead to an increased long-term stability of the metal-to-bone cement compound with decreased aseptic loosening in clinical use.
Mumme
T
T
Orthopädie, Universitätsklinikum Aachen. Torsten.Mumme@GMX.de
Marx
R
R
Andereya
S
S
Weber
M
M
Müller-Rath
R
R
Wirtz
D C
DC
D000268:Adhesiveness; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods*; D001843:Bone Cements / Q000032:analysis* / Q000737:chemistry; D002484:Cementation / Q000379:methods; D019544:Equipment Failure Analysis; D007720:Knee Prosthesis; D008422:Materials Testing; D008670:Metals / Q000032:analysis* / Q000737:chemistry; D011474:Prosthesis Design
D001843:Bone Cements; D008670:Metals