The Distribution of Implant Fixation for Femoral Components of TKA: A Postmortem Retrieval Study

Aseptic loosening of total knee arthroplasty (TKA) components is the foremost cause of implant failure in the long term. While tibial component loosening is of primary concern, femoral loosening may become a clinical problem due to younger, more active patients seeking TKA, and also high-flexion designs. In this study, we analyzed the fixation for 19 non-revised, postmortem retrieved, femoral components of TKA with time in service ranging from 1 to 22 years. We found that the average total contact fraction for cemented components was 9.5% and had a power law response (decrease) with years in service. The average initial interdigitation depth was 0.7 mm, and the average current interdigitation depth was 0.13 mm. Loss of interdigitation was 81%. Over all, minimal fixation seems necessary for long-term success of TKA femoral components.