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Background: The ability to utilize magnetic resonance imaging (MRI) to assess bony fixation may allow a better understanding of implant design and longevity. A new cementless total knee arthroplasty (TKA) was introduced, and we hypothesized that this cementless system would show similar fixation compared to a cemented system as assessed by multispectral MRI. Methods: Multiacquisition variable-resonance image combination selective MRI was performed in 20 patients implanted with a cementless TKA. A matched control group of 20 patients who had a cemented TKA was also evaluated. Each patellar, femoral, and tibial component was graded globally as well as by specific zones. The patella zones were medial, lateral, superior, and inferior. The femoral and tibial components were divided into 4 zones: anteromedial, anterolateral, posteromedial, and posterolateral. Integration grades were performed for each zone as follows: (1) normal, (2) fibrous tissue, (3) fluid interface, (4) osteolysis. A Chi-square test was performed to detect differences in level of integration grades between patients with cemented and those with cementless TKA. Results: At average 16-month follow-up, the cementless group grading noted 0/80 (0%) vs 2/76 (2.63%) patellar zones with fluid interface, 0/80 (0%) vs 26/80 (32.5%) femoral zones with fibrous tissue, and 10/80 (12.5%) vs 17/80 (21.25%) tibial zones with fibrous tissue. The analysis showed patellar (P < .001), femoral (P < .001), and tibial (P < .001) components had improved fixation and less percentage of fibrous tissue and fluid present in the cementless TKA. Conclusions: Utilizing metal suppression MRI, a newer cementless knee implant demonstrated excellent biologic fixation and improved fixation compared to the cemented group.

Abstract: This is the first long-term (mean 11.6years), prospective, matched-pair study (based on age, gender, BMI and UCLA scores) using MAVRIC (multi-acquisition variable-resonance image combination) magnetic resonance imaging to analyze reactive synovitis and osteolysis between rotating-platform posterior-stabilized (RP-PS), fixed-bearing metal-back (FB-MB), and all-polyethylene tibial (APT) in active patients (24 total, 8 in each group, mean age of 64years, mean UCLA of 8.5) with identical femoral component and polyethylene. Reactive synovitis was observed in 6 RP-PS (75%), all 8 FB-MB (100%), and 6 APT (75%). There was a significant difference between the RP-PS and FB-MB knees in volumetric synovitis (P =0.023). Osteolysis with bone loss more than 4mm was seen in 3 FB-MB, 2 APT and none for RP-PS. These were not statistically significant. [Copyright &y& Elsevier]

Background: The ability to utilize magnetic resonance imaging (MRI) to assess bony fixation may allow a better understanding of implant design and longevity. A new cementless total knee arthroplasty (TKA) was introduced, and we hypothesized that this cementless system would show similar fixation compared to a cemented system as assessed by multispectral MRI., Methods: Multiacquisition variable-resonance image combination selective MRI was performed in 20 patients implanted with a cementless TKA. A matched control group of 20 patients who had a cemented TKA was also evaluated. Each patellar, femoral, and tibial component was graded globally as well as by specific zones. The patella zones were medial, lateral, superior, and inferior. The femoral and tibial components were divided into 4 zones: anteromedial, anterolateral, posteromedial, and posterolateral. Integration grades were performed for each zone as follows: (1) normal, (2) fibrous tissue, (3) fluid interface, (4) osteolysis. A Chi-square test was performed to detect differences in level of integration grades between patients with cemented and those with cementless TKA., Results: At average 16-month follow-up, the cementless group grading noted 0/80 (0%) vs 2/76 (2.63%) patellar zones with fluid interface, 0/80 (0%) vs 26/80 (32.5%) femoral zones with fibrous tissue, and 10/80 (12.5%) vs 17/80 (21.25%) tibial zones with fibrous tissue. The analysis showed patellar ( P < .001), femoral ( P < .001), and tibial ( P < .001) components had improved fixation and less percentage of fibrous tissue and fluid present in the cementless TKA., Conclusions: Utilizing metal suppression MRI, a newer cementless knee implant demonstrated excellent biologic fixation and improved fixation compared to the cemented group., (© 2022 The Authors.)