High Bone Strains Help Us to Understand Migration of Cementless Tibial Baseplates

This study evaluated the relationship between bone strain patterns and early migration of cementless tibial baseplates following robotically assisted total knee arthroplasty (TKA). Ten patients undergoing cementless cruciate-retaining TKA had CT scans including a BMD reference phantom on the day of surgery and 6 weeks postoperatively. Gait analysis and biplane radiography was performed at six weeks postoperatively. Data from these evaluations were used for musculoskeletal modeling, finite element simulations. Implant migration was correlated with local bone strain distribution and bone density. Greater baseplate motion occurred in cases where high strains concentrated within denser bone, particularly in the posterior-medial region. Despite observed migration, all TKAs remained clinically successful. These findings suggest that load transfer and fixation biomechanics contribute to early implant motion and may improve understanding of cementless fixation behavior