The Effect of Surface Morphology on the Primary Fixation Strength of Uncemented Femoral Knee Prosthesis: A Cadaveric Study

We investigated the effect of surface morphology on the mechanical performance of uncemented femoral knee prosthesis. Eighteen implants were implanted on nine paired femurs and then pushed-off (left legs: a novel surface morphology; right legs: Porocoat as baseline). Bone mineral density (BMD) and anteroposterior dimension were not significantly different between groups. The insertion force was not significantly different, however, the loosening force was significantly higher in the novel group (P = 0.007). BMD had a direct relationship with the insertion and loosening force (P < 0.001). The effect of surface morphology on implant alignment was very small. We conclude that the surface properties create a higher frictional resistance, thereby providing a better inherent stability of implants featuring the novel surface morphology.