Loosening of tibia baseplates after total knee arthroplasty: Evaluation of pull-out strength of tibia baseplate-cement Interface.

Abstract Background Aseptic loosening is reported as the leading cause of revision total knee arthroplasty on the Australian National Joint Replacement Registry. Loosening of cemented tibial baseplates has been correlated with type of cement used, cementing technique, and cement contamination with biological material. The aim of this study was to evaluate the effect of cementing application and techniques including surface contamination and cement viscosity on fixation strength of tibia baseplates/cement interface. Methods Mechanical assessment of the fixation strength of tibia baseplates/cement interface was tested using a pull-out test on a material testing system. Different tibial baseplate design, cementing techniques, cement viscosity and contamination of the implant/cement interface with bone marrow were assessed to determine if they influenced force required to disrupt the cement/implant interface (pull-out strength). Findings The model with contamination of the cement prosthesis interface demonstrated a lower pull-out strength (p  Interpretations Biomechanical testing demonstrated improved fixation with cementing the tibial keel and keeping surfaces free from contamination during the cementation process.