Finite Element Analysis of the Influence of Cement Viscosity on Cement Mantle in Total Knee Arthroplasty

Aseptic loosening of the tibial implant is one of the major reasons of failure in Total Knee Arthroplasty (TKA). The cement viscosity at the time of application to the bone influences the cement penetration and stability of the prosthesis. Four cements of different viscosities and set times were selected for analysis (Simplex-P, DePuy-2, Palacos, and Endurance). Finite element analysis was used to model cement flow and cement mantle resulting from a surgically implanted tibial plate into sawbone open cell blocks simulating tibial cancellous bone (Pacific Research, WA). Frictional stress, pressure, sliding distance, and total stress at the bone-cement-stem interface were studied at the contact interfaces, which may contribute towards construct stability. Palacos had the maximum interface pressure, sliding distance, and total stress, while DePuy-2 displayed the lowest total stress and sliding distance at interface. Simulated flow profile correlated well with the cemented constructs’ radiographic profiles.