title: The protective effect of pulsed lavage against implant subsidence and micromotion for cemented tibial unicompartmental knee components: an experimental cadaver study.
abstract: Cemented UKAs were performed in 12 pairs of human cadaver legs and the bone bed was cleansed using pulsed lavage (group A) and conventional syringe lavage (group B). Subsidence and micromotion of the loaded tibial trays were measured. There was a significant effect of BMD on subsidence (P = 0.043) but not on micromotion. Cement penetration of group A was significantly increased (P = 0.005). Group A showed a reduced implant subsidence (P = 0.025) and micromotion (P = 0.026) compared to group B. The group differences in micromotion and implant subsidence of UKA tibial components were statistically significant but rather small and might clinically be of minor importance. Nevertheless a worse bone quality adversely affected implant subsidence and pulsed lavage had a protective effect in these specimens.
authors.affiliation: Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Jaeger
authors.affiliation: Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Johannes S
authors.initials: JS
authors.lastname: Rieger
authors.affiliation: Department of Medical Biometry, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.affiliation: Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: J Philippe
authors.initials: JP
authors.lastname: Kretzer
authors.affiliation: Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany; Vulpius Hospital for Orthopaedic Surgery Bad Rappenau, Rappenau, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Clarius
authors.affiliation: Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Rudi G
authors.initials: RG
authors.lastname: Bitsch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D015519:Bone Density; D002102:Cadaver; D002484:Cementation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D007507:Therapeutic Irrigation; D013977:Tibia / Q000503:physiopathology / Q000601:surgery*
keywords: BMD; cement penetration; implant subsidence; micromotion; pulsed lavage; unicompartmental