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Clinical Orthopaedics and Related Research®

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01-01-2013 | Symposium: Papers Presented at the Annual Meetings of the Knee Society

Aseptic Tibial Debonding as a Cause of Early Failure in a Modern Total Knee Arthroplasty Design

Authors: Diren Arsoy, MD, Mark W. Pagnano, MD, David G. Lewallen, MD, Arlen D. Hanssen, MD, Rafael J. Sierra, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 1/2013

Abstract

Background

We observed isolated tibial component debonding from the cement in one modern primary TKA design (NexGen LPS 3° tibial tray; Zimmer, Warsaw, IN, USA). This failure mechanism is sparsely reported in the literature.

Questions/Purposes

We (1) assessed survivorship of this tibial tray with special emphasis on debonding; (2) described clinical and radiographic features associated with tibial failure; and (3) compared patient and radiographic features of the failures with a matched cohort.

Methods

A total of 1337 primary TKAs were performed with a cemented NexGen LPS 3° tibial tray over an 11-year period. Twenty-five knees (1.9%) were revised for tibial debonding. BMI and radiographic alignment in the tibial debonding group were compared with a matched control group. Implant survivorship was assessed using tibial debonding as the end point.

Results

Survival free of revision from tibial debonding was 100% at 1 year and 97.8% at 5 years. The tibial failures shared a typical radiographic pattern with debonding at the cement-implant interface and subsidence into varus and flexion. We found no link between limb alignment or individual component alignment and failure because 22 of the 25 failures occurred in well-aligned knees.

Conclusions

Our standardized followup of patients undergoing TKA at routine intervals allowed us to discover a higher rate of revision resulting from tibial debonding. We have discontinued the use of this particular tibial tray for primary TKA and surveillance for patients undergoing TKA continues to be warranted.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: Aseptic Tibial Debonding as a Cause of Early Failure in a Modern Total Knee Arthroplasty Design
Authors: Diren Arsoy, MD
Mark W. Pagnano, MD
David G. Lewallen, MD
Arlen D. Hanssen, MD
Rafael J. Sierra, MD
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 1/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2467-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Aseptic Tibial Debonding as a Cause of Early Failure in a Modern Total Knee Arthroplasty Design

Abstract

Background

Questions/Purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/Purposes

Methods

Results

Conclusions

Level of Evidence

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