The Role of CarboJet in the Reduction of Aseptic Loosening
April 27, 2015
Recent evidence from a large multicenter study shows that aseptic loosening has become the single largest cause of failure of modern primary knee arthroplasties requiring revision. Earlier studies, conducted in the 1990s, had shown polyethylene wear to be the leading cause of failure. The more current study found that 28.0% of all knee failures were due to aseptic loosening, comprising the single most common failure mode. In the case of unicompartmental knees, 60.6% of failures were due to aseptic loosening. A significant portion of the aseptic loosening failures were early failures, with 32.9% of these failures classified as never successful, suggesting failure of initial fixation.
These findings suggest that meticulous attention to cement technique and proper preparation of the bone bed prior to cementation may improve implant longevity and quality outcomes. There is also considerable evidence suggesting that increased cement penetration depth into the bone bed improves cement mantle toughness and reduces cement-bone interface stresses. Of particular note, a recent tibial component retrieval study showed that there is a time dependent resorption of interlocking trabecular bone away from the cement mantle. This progressive loss of cement interdigitation with time in service suggests that it is important to ensure maximum cement penetration and interdigitation at implantation…