Open-Sided Tibial Tray to Poly Insert Interface Does Not Generate Peripheral Fluid Flow Under Cyclic Loading

Previous clinical publications have identified osteolysis and periprosthetic bone resorption around total knee and hip implants as a contributor to loss of implant fixation [1,2,3,4]. Fluid pressure near fixation screw holes has been studied for both its potential to drive osteolytic polyethylene debris into surrounding cancellous bone and its potential as an isolated mechanism for causing bone resorption [5,6,7]. The interaction between joint capsule pressure, cyclic loading, and lytic lesions near fixation screw holes has also been the focus of prior work [8]. Increases in joint capsule pressure and cyclic loading were both shown to cause fluid to migrate to the site of osteolytic lesions near screw holes, increasing pressure within the lesion. However, cyclic loading was not shown to increase the joint capsule driving pressure.