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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 1, 39-44.
doi: 10.1302/0301-620X.89B1.17974  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Cemented versus hydroxyapatite fixation of the femoral component of the Freeman-Samuelson total knee replacement

A RADIOSTEREOMETRIC ANALYSIS

J. Uvehammer, MD, PhD, Orthopaedic Surgeon1; J. Kärrholm, MD, PhD, Professor2; and L. Carlsson, MD, PhD, Professor2

1 Department of Orthopaedics, Lidköping Hospital, SE-531 85 Lidköping, Sweden.
2 Department of Orthopaedics, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.

Correspondence should be sent to Dr J. Uvehammer; e-mail: uvehammer{at}hotmail.com

We have carried out a radiostereometric study of 50 patients (54 knees) with osteoarthritis of the knee who were randomly allocated to receive a cemented or a hydroxyapatite-coated femoral component for total knee replacement. The patients were also stratified to receive one of three types of articulating surface (standard, rotating platform, Freeman-Samuelson (FS)1000) all based on the Freeman-Samuelson design. The tibial components were cemented in all cases. Radiostereometry was performed post-operatively and at 3, 12 and 24 months. The analysis was restricted to rotation of the femoral component over time.

After two years, rotation of the femoral components in the transverse, longitudinal and sagittal planes did not differ between the cemented and the hydroxyapatite-coated implants (p = 0.2 to 0.9).

In total knee replacements with a rotating platform, the femoral component tended to tilt more posteriorly than in the other two designs, regardless of the choice of fixation (cemented or hydroxyapatite-coated, p = 0.04). The standard version of the femoral component, whether cemented or hydroxyapatite-coated, rotated more into valgus than was observed with the rotating-platform and FS1000 designs (p = 0.005). The increased constraint provided by the FS1000 component did not appear to have any adverse effect on fixation of the femoral component.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General