Despite recent advancements in implant design and cement technique, aseptic tibial loosening remains the primary cause of revision after cemented total knee arthroplasty (TKA) [1]. While the mechanisms of tibial loosening are multifactorial, previous research has shown that third-generation cement techniques, including the use of jet lavage and cement pressurization, can reduce contamination of the implant surface by lipids endogenous to the surrounding cancellous bone and thereby enhance fixation strength between the implant and bone [2]. The purpose of this thesis is to understand the role contaminating lipids play in the mechanism of aseptic loosening and to perform a cadaveric study on modern commercially available TKA systems to evaluate their ability to mitigate the risks of poor fixation. The results from this study indicate that tibial components with no cement mantle around the cone or keel structure provide greater fixation and enhanced robustness to intraoperative knee balance assessment manipulations.
","abstract_html":"<p>Despite recent advancements in implant design and cement technique, aseptic tibial loosening remains the primary cause of revision after cemented total knee arthroplasty (TKA) [1]. While the mechanisms of tibial loosening are multifactorial, previous research has shown that third-generation cement techniques, including the use of jet lavage and cement pressurization, can reduce contamination of the implant surface by lipids endogenous to the surrounding cancellous bone and thereby enhance fixation strength between the implant and bone [2]. The purpose of this thesis is to understand the role contaminating lipids play in the mechanism of aseptic loosening and to perform a cadaveric study on modern commercially available TKA systems to evaluate their ability to mitigate the risks of poor fixation. The results from this study indicate that tibial components with no cement mantle around the cone or keel structure provide greater fixation and enhanced robustness to intraoperative knee balance assessment manipulations.</p>","abstract_has_math":false,"creators":["Behnam, Yashar Ali"],"institution":null,"degree_name":"M.S.","degree_level":"Masters Thesis","degree_discipline":null,"degree_department":null,"school":null,"contributors":["Chadd W. Clary, Ph.D."],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2019,"date_issued":"2019-01-01T08:00:00Z","date_published":"2019-01-01T08:00:00Z","updated_at":"2026-07-24T02:03:35Z","subjects":["Fixation strength","Knee balance assessment","Lipid contamination","Lipid marrow infiltration","Total knee arthroplasty","Engineering","Mechanical Engineering"],"languages":["en"],"rights":["Copyright is held by the author. User is responsible for all copyright compliance.
"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://digitalcommons.du.edu/etd/1564","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Chadd W. Clary, Ph.D."]},{"key":"dc:creator","label":"Author","values":["Behnam, Yashar Ali"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2021-08-01T07:00:00Z"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Masters Thesis"]},{"key":"thesis:degree_name","label":"Degree Name","values":["M.S."]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Fixation strength","Knee balance assessment","Lipid contamination","Lipid marrow infiltration","Total knee arthroplasty","Engineering","Mechanical Engineering"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["Copyright is held by the author. User is responsible for all copyright compliance.
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"]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Knee Balance Assessment During Cementation Is Detrimental to Initial TKA Tibial Tray Fixation"]}]}],"canonical_facts":{"dc:contributor":["Chadd W. Clary, Ph.D."],"dc:creator":["Behnam, Yashar Ali"],"dc:date.available":["2021-08-01T07:00:00Z"],"dc:description.abstract":["Despite recent advancements in implant design and cement technique, aseptic tibial loosening remains the primary cause of revision after cemented total knee arthroplasty (TKA) [1]. While the mechanisms of tibial loosening are multifactorial, previous research has shown that third-generation cement techniques, including the use of jet lavage and cement pressurization, can reduce contamination of the implant surface by lipids endogenous to the surrounding cancellous bone and thereby enhance fixation strength between the implant and bone [2]. The purpose of this thesis is to understand the role contaminating lipids play in the mechanism of aseptic loosening and to perform a cadaveric study on modern commercially available TKA systems to evaluate their ability to mitigate the risks of poor fixation. The results from this study indicate that tibial components with no cement mantle around the cone or keel structure provide greater fixation and enhanced robustness to intraoperative knee balance assessment manipulations.
"],"dc:format":["application/pdf"],"dc:identifier":["https://digitalcommons.du.edu/etd/1564"],"dc:language":["en"],"dc:rights":["Copyright is held by the author. User is responsible for all copyright compliance.
"],"dc:subject":["Fixation strength","Knee balance assessment","Lipid contamination","Lipid marrow infiltration","Total knee arthroplasty","Engineering","Mechanical Engineering"],"dc:title":["Knee Balance Assessment During Cementation Is Detrimental to Initial TKA Tibial Tray Fixation"],"thesis:degree_level":["Masters Thesis"],"thesis:degree_name":["M.S."]},"updated_at":"2026-07-24T02:03:35Z"}