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Title: Femoral component loosening in high-flexion total knee replacement: An in vitro comparison of high-flexion versus conventional designs
Authors: Bollars, Peter ×
Bellemans, Johan
Luyckx, Jean-Philippe
Innocenti, Bernardo
Labey, Luc
Victor, Jan #
Issue Date: Oct-2011
Publisher: Published for the British Editorial Society of Bone & Joint Surgery by Churchill Livingstone
Series Title: Journal of Bone and Joint Surgery. British Volume vol:93 issue:10 pages:1355-1361
Abstract: High-flexion total knee replacement (TKR) designs have been introduced to improve flexion after TKR. Although the early results of such designs were promising, recent literature has raised concerns about the incidence of early loosening of the femoral component. We compared the minimum force required to cause femoral component loosening for six high-flexion and six conventional TKR designs in a laboratory experiment. Each TKR design was implanted in a femoral bone model and placed in a loading frame in 135° of flexion. Loosening of the femoral component was induced by moving the tibial component at a constant rate of displacement while maintaining the same angle of flexion. A stereophotogrammetric system registered the relative movement between the femoral component and the underlying bone until loosening occurred. Compared with high-flexion designs, conventional TKR designs required a significantly higher force before loosening occurred (p < 0.001). High-flexion designs with closed box geometry required significantly higher loosening forces than high-flexion designs with open box geometry (p = 0.0478). The presence of pegs further contributed to the fixation strength of components. We conclude that high-flexion designs have a greater risk for femoral component loosening than conventional TKR designs. We believe this is attributable to the absence of femoral load sharing between the prosthetic component and the condylar bone during flexion.
URI: 
ISSN: 0301-620X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Orthopaedics Section (-)
Biomechanics Section
Clinical Residents Medicine
Medicine Teaching Programs
× corresponding author
# (joint) last author

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