Early aseptic loosening of the tibial component at the cement-implant interface in total knee arthroplasty: a narrative overview of potentially associated factors

Abstract

Total knee arthroplasty (TKA) is a highly effective surgical procedure, but in some patients TKAs fail early due to a variety of underlying factors. About 11% of revision TKAs within one year of primary TKA are the result of aseptic loosening of the tibial component at the cement-implant interface. Literature regarding the most important factors associated with this type of loosening is scarce. The objective is to give an overview of the literature regarding factors associated with aseptic loosening of the tibia component at the cement-implant interface in total knee arthroplasty. A narrative literature review based on publications identified through PubMed and CINAHL databases. Twelve studies were identified, which describe a total of 299 cases of early aseptic loosening of the tibia component at the cement-implant interface. The main associated factors reported were cementa- tion factors. These factors included the use of high viscosity cement (HVC), cement application methods and cement thickness. Other main reported associated factor related to implant design factors, which included component shape and surface roughness. The least frequently reported associated factors related to the patient characteristics of body mass index (BMI). Several factors associated with early aseptic loosening of the tibial component at the cement-implant inter- face in total knee arthroplasty were identified in this review. The most frequently reported associated factors related to cementation factors and implant design factors. Because the literature in this area is scarce, further research is warranted in an effort to prevent early aseptic loosening in future TKAs.