Loosening of the tibial component after total knee arthroplasty (TKA) is a common indication for revision.

Increasing the strength of the initial tibial implant/cement interface is desirable.

There is little information about the surgical techniques that lead to the highest strength. We investigated the effects of eight variables on the strength of the initial tibial baseplate/cement interface.

A total of 48 tibial trays were cemented into acrylic holders using cement from two manufacturers, at three different times (early, normal, and late) using two techniques: cementing the tibial plateau or the plateau and the keel; and involving two conditions of contamination with marrow fat (at the metal/cement and cement/cement interfaces).

Push-out tests were performed with load continuously recorded.