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The progression of the loosening process, from the initial well\u2010fixed component, is not fully understood. In this study, loss of fixation of cemented hemiarthroplasty was explored using 9\u2010month\u2010old Sprague\u2013Dawley rats with 0, 2, 6, 12, 26 week end points. Morphological and cellular changes of cement\u2013bone fixation were determined for regions directly below the tibial tray (epiphysis) and distal to the tray (metaphysis). Loss of fixation, with a progressive increase in cement\u2013bone gap volume was found in the epiphysis (0.162\u2009 mm<jats:sup>3<\/jats:sup>\/week), but did not progress appreciably in the metaphysis (0.007\u2009mm<jats:sup>3<\/jats:sup>\/week). In the epiphysis, there was an early and sustained elevation of osteoclasts adjacent to the cement border and development of a fibrous tissue layer between the cement and bone. There was early formation of bone around the cement in the metaphysis, resulting in a condensed bone layer without osteoclastic bone resorption or development of a fibrous tissue layer. Implant positioning was also an important factor in the cement\u2013bone gap formation, with greater gap formation for implants that were placed medially on the tibial articular surface. Loss of fixation in the rat model mimicked patterns found in human arthroplasty where cement\u2013bone gaps initiate under the tibial tray, at the periphery of the implant. This preclinical model could be used to study early biological response to cemented fixation and associated contributions of mechanical instability, component alignment, and periprosthetic inflammation.<\/jats:p>","DOI":"10.1002\/jor.24977","type":"journal-article","created":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T14:06:48Z","timestamp":1609423608000},"page":"2353-2362","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Progressive loss of implant fixation in a preclinical rat model of cemented knee arthroplasty"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1150-0740","authenticated-orcid":false,"given":"Kenneth A.","family":"Mann","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery SUNY Upstate Medical University Syracuse New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark 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