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Nicholson AD, Mathew JI, Koch CN, Kontaxis A, Wright T, Taylor SA, Blaine TA, Dines JS, Dines DM, Fu MC, Warren RF, Gulotta LV. Backside polyethylene wear in reverse shoulder arthroplasty. J Shoulder Elbow Surg 2022; 31:545-552. [PMID: 34619352 DOI: 10.1016/j.jse.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Aseptic loosening from implant-associated osteolysis in reverse shoulder arthroplasty (RSA) may contribute to premature implant failure. Although articular side polyethylene (PE) damage has been well documented in the literature, no studies to date have investigated backside wear in RSA. The aims of this investigation were to (1) document and compare the damage between the backside and articular surface in explanted RSA components, (2) assess whether certain quadrants have a greater propensity for damage, and (3) report the most common mode(s) of backside PE damage. METHODS Twenty-one RSA humeral liners retrieved during revision procedures between 2005 and 2014 were included for analysis. The mean time between implantation and extraction was 16 months (10 days-88 months). Diagnoses at the time of revision included dislocation (10), infection (4), mechanical failure (3), loosening (2), and unknown (2). Liners were examined under light microscopy (×10-30 magnification) and damage on the articular and backside of the liner surface was graded using the modified Hood score. The location and damage modality were compared between the articular side and backside of the implant. RESULTS Damage was noted on the articular surfaces of all 21 liners and on the backside surface of 20 liners. The total damage in all the quadrants was higher on the articular surface than on the backside of the component, with a mean difference in total quadrant damage scores of 11.74 ± 3.53 (P < .001). There was no difference in damage among the quadrants on the backside (P = .44) or the articular surface (P = .08). The articular side exhibited greater scratching, abrasion, and surface deformation than the backside (P < .001). CONCLUSIONS This short-term retrieval study demonstrated that backside PE damage occurs on the humeral component of RSA implants. There was greater damage to the articular side of the liner but wear to the backside was present in almost all liners. The clinical importance of backside wear in RSA and its overall contribution to PE particulate disease and osteolysis needs further investigation.
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Lee JM, Ha C, Jung K, Choi W. Clinical Results after Design Modification of Lospa Total Knee Arthroplasty System: Comparison between Posterior-Stabilized (PS) and PS Plus Types. Clin Orthop Surg 2022; 14:236-243. [PMID: 35685967 PMCID: PMC9152896 DOI: 10.4055/cios20308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/12/2021] [Accepted: 04/26/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Cheungsoo Ha
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Kyunghun Jung
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Wonchul Choi
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Bhalekar RM, Nargol ME, Shyam N, Nargol AVF, Wells SR, Collier R, Pabbruwe M, Joyce TJ, Langton DJ. Tibial tray debonding from the cement mantle is associated with deformation of the backside of polyethylene tibial inserts. Bone Joint J 2021; 103-B:1791-1801. [PMID: 34474593 DOI: 10.1302/0301-620x.103b.bjj-2020-2555.r2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The aim of this study was to investigate whether wear and backside deformation of polyethylene (PE) tibial inserts may influence the cement cover of tibial trays of explanted total knee arthroplasties (TKAs). METHODS At our retrieval centre, we measured changes in the wear and deformation of PE inserts using coordinate measuring machines and light microscopy. The amount of cement cover on the backside of tibial trays was quantified as a percentage of the total surface. The study involved data from the explanted fixed-bearing components of four widely used contemporary designs of TKA (Attune, NexGen, Press Fit Condylar (PFC), and Triathlon), revised for any indication, and we compared them with components that used previous generations of PE. Regression modelling was used to identify variables related to the amount of cement cover on the retrieved trays. RESULTS A total of 114 explanted fixed-bearing TKAs were examined. This included 76 used with contemporary PE inserts which were compared with 15 used with older generation PEs. The Attune and NexGen (central locking) trays were found to have significantly less cement cover than Triathlon and PFC trays (peripheral locking group) (p = 0.001). The median planicity values of the PE inserts used with central locking trays were significantly greater than of those with peripheral locking inserts (205 vs 85 microns; p < 0.001). Attune and NexGen inserts had a characteristic pattern of backside deformation, with the outer edges of the PE deviating inferiorly, leaving the PE margins as the primary areas of articulation. CONCLUSION Explanted TKAs with central locking mechanisms were significantly more likely to debond from the cement mantle. The PE inserts of these designs showed characteristic patterns of deformation, which appeared to relate to the manufacturing process and may be exacerbated in vivo. This pattern of deformation was associated with PE wear occurring at the outer edges of the articulation, potentially increasing the frictional torque generated at this interface. Cite this article: Bone Joint J 2021;103-B(12):1791-1801.
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Affiliation(s)
| | | | | | | | | | - Ryan Collier
- Centre for Implant Technology and Retrieval Analysis, Department of Medical Engineering and Physics, Royal Perth Hospital, Perth, Australia
| | - Moreica Pabbruwe
- Centre for Implant Technology and Retrieval Analysis, Department of Medical Engineering and Physics, Royal Perth Hospital, Perth, Australia
| | - Thomas J Joyce
- School of Engineering, Newcastle University, Newcastle upon Tyne, UK
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Abstract
BACKGROUND Revision of TKA as a result of polyethylene wear is decreasing, but long-term wear performance of polyethylene is still a topic of interest to surgeons and device manufacturers seeking to improve longevity. Measuring wear of modern, wear-resistant implants has been described using radiostereometric analysis (RSA). Performing in vivo measurements would establish whether implant retrieval studies are representative of wear in well-performing knees. QUESTIONS/PURPOSES For a single knee implant system, we sought to determine (1) the linear wear rate using RSA; (2) the association between demographic factors and wear rate; and (3) the association between limb alignment and wear rate. METHODS A total of 49 patients with a minimum followup of 10 years (median, 12 years; range, 10-20 years) were retrospectively selected. During the examined period, 4082 TKAs were performed of which 2085 were the implant examined in this study. There were 71 of these patients who met the criteria including an available full-leg radiograph postoperatively, and 34 of these patients returned for examination along with 15 additional from a separate RSA study that also met the criteria. All patients received a posterior-stabilized, cobalt-chromium-on-conventional polyethylene total knee implant from a single implant system, which was the most commonly used at our institution at the time. Patients underwent standing RSA examinations from 0° to 120° of flexion at a single time point without the use of marker beads. Linear wear rates (including creep) were measured based on intersections between the femoral component and tibial insert models. Associations between wear and patient age at surgery, sex, height, weight, body mass index, tibial insert size, and limb alignment were examined. RESULTS Using the maximum linear wear rate from any flexion angle, the lateral rate was 0.047 mm/year (interquartile range [IQR], 0.034-0.066 mm/year) and the medial rate was 0.052 mm/year (IQR, 0.040-0.069 mm/year). Using the median of the linear wear rates across all flexion angles, the lateral rate was 0.027 mm/year (IQR, 0.017-0.046 mm/year) and the medial rate was 0.038 mm/year (IQR, 0.022-0.054 mm/year). This rate for males was 0.049 mm/year medially (IQR, 0.042-0.077 mm/year) and 0.032 mm/year laterally (IQR, 0.026-0.059 mm/year), and for females was 0.027 mm/year medially (0.016-0.039 mm/year) and 0.020 mm/year laterally (IQR, 0.013-0.032 mm/year). The wear rate for males was greater medially (difference = 0.022 mm/year, p < 0.001) and laterally (difference = 0.012 mm/year, p = 0.008). There were associations between greater wear and increasing height (ρ = 0.48, p < 0.001 medially and ρ = 0.30, p = 0.04 laterally), decreasing body mass index (ρ = -0.31, p = 0.03 medially), and greater implant size (ρ = 0.34, p = 0.02 medially). Increasingly varus leg alignment was associated with greater medial wear (ρ = 0.33, p = 0.02). CONCLUSIONS Greater wear rates were associated with demographic factors and leg alignment. Further RSA wear studies of other modern implant systems would provide complementary information to retrieval studies and valuable data on wear resistance. CLINICAL RELEVANCE Good wear resistance was demonstrated by well-performing implants in patients at long-term followup with wear magnitudes in agreement with reported values from retrieval studies.
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Current Total Knee Designs: Does Baseplate Roughness or Locking Mechanism Design Affect Polyethylene Backside Wear? Clin Orthop Relat Res 2017; 475:2970-2980. [PMID: 28905208 PMCID: PMC5670066 DOI: 10.1007/s11999-017-5494-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 08/31/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Tibial baseplate roughness and polyethylene-insert micromotion resulting from locking-mechanism loosening can lead to polyethylene backside wear in TKAs. However, many retrieval studies examining these variables have evaluated only older TKA implant designs. QUESTIONS We used implant-retrieval analysis to examine if there were differences in: (1) backside damage scores, (2) backside damage modes, and (3) backside linear wear rates in five TKA implant designs owing to differing baseplate surface roughness and locking mechanisms. Additionally, we examined if (4) patient demographics influence backside damage and wear. METHODS Five TKA implant models (four modern and one historical design) were selected with different tibial baseplate and/or locking mechanism designs. Six tibial inserts retrieved at the time of revision from each TKA model were matched for time in vivo, age of the patient at TKA revision, BMI, sex, revision number, and revision reason. Each insert backside was analyzed for: (1) visual total damage score and (2) individual visual damage modes, both by two observers and with an intraclass correlation coefficient of 0.66 (95% CI, 0.39-0.92), and (3) linear wear rate measured by micro-CT. Median primary outcomes were compared among the five designs. For our given sample size among five groups we could detect with 80% power a 10-point difference in damage score and an 0.11-mm per year difference in wear rate. RESULTS The polished tibial design with a partial peripheral capture locking mechanism and anterior constraint showed a lower total damage score compared with the nonpolished tibial design with only a complete peripheral-rim locking mechanism (median, 12.5; range, 9.5-18.0; 95% CI, 9.58-16.42 versus median, 22.3; range, 15.5-27.0; 95% CI, 17.5-26.5; p = 0.019). The polished baseplate with a tongue-in-groove locking mechanism showed more abrasions than the nonpolished baseplate with a peripheral-rim capture and antirotational island (median, 7.25; range, 0.5-8.0; 95% CI, 2.67-8.99 versus median, 0.75; range, 0-1.5; 95% CI, 0.20-1.47; p = 0.016)). Dimpling was a unique wear mode to the nonpolished baseplates with the peripheral-rim capture and antirotational island (median, 5.5; range, 2.0-9.0; 95% CI, 2.96-8.38) and the peripheral-rim capture alone (median, 9.0; range, 6.0-10.0; 95% CI, 7.29-10.38). Overall, the linear wear rate for polished designs was lower than for nonpolished designs (0.0102 ± 0.0044 mm/year versus 0.0224 ± 0.0119 mm/year; p < 0.001). Two of the polished baseplate designs, the partial peripheral capture with anterior constraint (median, 0.083 mm/year; range, 0.0037-0.0111 mm/year; 95% CI, 0.0050-0.0107 mm versus median, 0.0245 mm/year; range, 0.014-0.046 mm/year; 95% CI, 0.0130-0.0414 mm; p = 0.008) and the tongue-in-groove locking mechanism (median, 0.0085 mm/year; range, 0.005-0.015 mm/year; 95% CI, 0.0045-0.0138 mm; p = 0.032) showed lower polyethylene linear wear rates compared with the nonpolished baseplate design with only a peripheral-rim capture. CONCLUSIONS Total damage scores and linear wear rates were highest involving the nonpolished design with only a peripheral rim capture. There were no differences among the other TKA designs regarding damage and wear, but this finding should be considered in the setting of a relatively small sample size. CLINICAL RELEVANCE Our study showed that in the complex interplay between baseplate surface finish and locking mechanism design, a polished baseplate with a robust locking mechanism had the lowest backside damage and linear wear. However, improvements in locking mechanism design in nonpolished baseplates potentially may offset some advantages of a polished baseplate. Further retrieval analyses need to be done to confirm such findings, especially analyzing current crosslinked polyethylene. Additionally, we need mid- and long-term studies comparing TKA revisions attributable to wear and osteolysis among implants before understanding if such design differences are clinically relevant.
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Łapaj Ł, Mróz A, Kokoszka P, Markuszewski J, Wendland J, Helak-Łapaj C, Kruczyński J. Peripheral snap-fit locking mechanisms and smooth surface finish of tibial trays reduce backside wear in fixed-bearing total knee arthroplasty. Acta Orthop 2017; 88:62-69. [PMID: 27781667 PMCID: PMC5251266 DOI: 10.1080/17453674.2016.1248202] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 07/31/2016] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Severe backside wear, observed in older generations of total knee replacements (TKRs), led to redesign of locking mechanisms to reduce micromotions between tibial tray and inlay. Since little is known about whether this effectively reduces backside wear in modern designs, we examined backside damage in retrievals of various contemporary fixed-bearing TKRs. Patients and methods - A consecutive series of 102 inlays with a peripheral (Stryker Triathlon, Stryker Scorpio, DePuy PFC Sigma, Aesculap Search Evolution) or dovetail locking mechanism (Zimmer NexGen, Smith and Nephew Genesis II) was examined. Articular and backside surface damage was evaluated using the semiquantitative Hood scale. Inlays were examined using scanning electron microscopy (SEM) to determine backside wear mechanisms. Results - Mean Hood scores for articular (A) and backside (B) surfaces were similar in most implants-Triathlon (A: 46, B: 22), Genesis II (A: 55, B: 24), Scorpio (A: 57, B: 24), PFC (A: 52, B: 20); Search (A: 56, B: 24)-except the NexGen knee (A: 57, B: 60), which had statistically significantly higher backside wear scores. SEM studies showed backside damage caused by abrasion related to micromotion in designs with dovetail locking mechanisms, especially in the unpolished NexGen trays. In implants with peripheral liner locking mechanism, there were no signs of micromotion or abrasion. Instead, "tray transfer" of polyethylene and flattening of machining was observed. Interpretation - Although this retrieval study may not represent well-functioning TKRs, we found that a smooth surface finish and a peripheral locking mechanism reduce backside wear in vivo, but further studies are required to determine whether this actually leads to reduced osteolysis and lower failure rates.
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Affiliation(s)
- Łukasz Łapaj
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznań University of Medical Sciences
| | | | - Paweł Kokoszka
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznań University of Medical Sciences
| | - Jacek Markuszewski
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznań University of Medical Sciences
| | - Justyna Wendland
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznań University of Medical Sciences
| | - Celina Helak-Łapaj
- Department of Bioinformatics and Computational Biology, Poznań University of Medical Sciences
- Clinical Eye Unit and Pediatric Ophtalmology Service, Heliodor Swiecicki University Hospital, Poznań University of Medical Sciences, Poznań, Poland
| | - Jacek Kruczyński
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznań University of Medical Sciences
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Does Achieving High Flexion Increase Polyethylene Damage in Posterior-Stabilized Knees? A Retrieval Study. J Arthroplasty 2017; 32:274-279. [PMID: 27519961 DOI: 10.1016/j.arth.2016.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 06/28/2016] [Accepted: 07/05/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Increased range of motion to higher degrees of flexion following total knee arthroplasty has been postulated to increase implant damage and revision rates, even in designs modified to accommodate high flexion. METHODS We examined posterior-stabilized and high-flexion retrieved tibial inserts to look for differences in polyethylene surface damage with light microscopy and 3D deviation with laser scanning between inserts from patients who achieved a high degree of flexion (≥120° postoperatively) and inserts from patients who did not reach a high degree of flexion. RESULTS No differences were found in damage scores on the articular and backside surfaces, except for abrasion in the posterior articular regions, or in 3D deviations between patients who reached a high degree of flexion and patients who did not. These results were independent of the reason for revision. CONCLUSION In our series, reaching a high degree of flexion did not influence surface damage or 3D deviation of the polyethylene inserts.
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Kajetanek C, Bouyer B, Ollivier M, Boisrenoult P, Pujol N, Beaufils P. Mid-term survivorship of Mini-keel™ versus Standard keel in total knee replacements: Differences in the rate of revision for aseptic loosening. Orthop Traumatol Surg Res 2016; 102:611-7. [PMID: 27364965 DOI: 10.1016/j.otsr.2016.05.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 04/27/2016] [Accepted: 05/02/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION To reduce the size of the surgical incision, modular mini-keel tibial components have been developed with or without extensions for the Nexgen™ MIS Tibial Component. Although a smaller component could theoretically result in defective fixation, this has never been evaluated in a large comparative series. Thus, we performed the following case control study to: (1) evaluate intermediate-term survival of a modular "mini-keel" tibial component compared to a reference standard keel component from the same line of products (Nexgen LPS-Flex Tibial Component, Zimmer); (2) to identify any eventual associated factors if the frequency of loosening was increased. HYPOTHESIS The rate of revision for aseptic tibial loosening is comparable for both components. MATERIALS AND METHODS This comparative, retrospective, single center series of 459 consecutive total knee arthroplasties (TKA) was performed between 2007 and 2010: with 212 modular "mini-keel" (MK) tibial components and 247 "standard" (S) components. Survival, rate of revision for aseptic tibial loosening and identification of a radiolucent line were analyzed at the final follow-up. RESULTS After a median follow-up of 5years, the rate of revision for tibial aseptic loosing was significantly higher in the MK group with 12 cases (5.7%) and 4 cases in the S group (1.6%) (P=0.036). The use of the MK component appears to be a prognostic factor for surgical revision (hazard ratio=3.86 (1.23-11.88), P=0.02) but not for the development of a radiolucent line (HR=1.75 (0.9-3.4), P=0.097). The mean delay before revision was 38months (8-64) in the MK group and 15.2months (8-22) in the S group (P=0.006). Individual factors, such as gender, body mass index (BMI) and pre- or postoperative alignment were not prognostic factors for revision or radiolucent lines. CONCLUSION The modular "mini-keel" tibial component was associated with a greater risk of revision for tibial component loosening. LEVEL OF EVIDENCE Case control study, III.
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Affiliation(s)
- C Kajetanek
- Service de chirurgie orthopédique, hôpital André-Mignot, centre hospitalier Versailles, 177, rue de Versailles, 78157 Le Chesnay, France.
| | - B Bouyer
- Service de chirurgie orthopédique, hôpital André-Mignot, centre hospitalier Versailles, 177, rue de Versailles, 78157 Le Chesnay, France
| | - M Ollivier
- Service de chirurgie orthopédique, hôpital André-Mignot, centre hospitalier Versailles, 177, rue de Versailles, 78157 Le Chesnay, France
| | - P Boisrenoult
- Service de chirurgie orthopédique, hôpital André-Mignot, centre hospitalier Versailles, 177, rue de Versailles, 78157 Le Chesnay, France
| | - N Pujol
- Service de chirurgie orthopédique, hôpital André-Mignot, centre hospitalier Versailles, 177, rue de Versailles, 78157 Le Chesnay, France
| | - P Beaufils
- Service de chirurgie orthopédique, hôpital André-Mignot, centre hospitalier Versailles, 177, rue de Versailles, 78157 Le Chesnay, France
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Holleyman RJ, Scholes SC, Weir D, Jameson SS, Holland J, Joyce TJ, Deehan DJ. Changes in surface topography at the TKA backside articulation following in vivo service: a retrieval analysis. Knee Surg Sports Traumatol Arthrosc 2015; 23:3523-31. [PMID: 25100486 DOI: 10.1007/s00167-014-3197-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 07/16/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE With the advent of modular total knee arthroplasty (TKA) systems, backside wear at the articulation between the ultra-high-molecular-weight-polyethylene (UHMWPE) component undersurface and the tibial baseplate has received increasing attention as a source of clinically significant polyethylene wear debris. The aim of this study was to investigate the reciprocating interface at the TKA undersurface articulation using profilometry after in vivo service. Our null hypothesis was that there would be no discernible pattern or relationship between the metal tibial baseplate and UHMWPE surface profile. METHODS A nanoscale analysis of thirty retrieved fixed-bearing TKA explants was performed. Surface roughness (Sa) and skewness (Ssk) were measured on both the UHMWPE component undersurface and the tibial baseplate of explants using a non-contacting profilometer (1 nm resolution). Four pristine unimplanted components of two different designs (Stryker Kinemax and DePuy PFC) were examined for control purposes. RESULTS Mean explant baseplate surface roughness was 1.24 μm (0.04-3.01 μm). Mean explant UHMWPE undersurface roughness was 1.16 μm (0.23-2.44 μm). Each explant had an individual roughness pattern with unique baseplate and undersurface UHMWPE surface roughness that was different from, but closely related to, surface topography observed in control implants of the same manufacturer and design. Following in vivo service, UHMWPE undersurface showed changes towards a negative skewness, demonstrating that wear is occurring at the backside interface. CONCLUSION In vivo loading of the TKA prosthesis leads to measurable changes in surface profile at the backside articulation, which appear to be dependent on several factors including implant design and in vivo duration. These findings are consistent with wear occurring at this surface. Findings of this study would support the use of a polished tibial tray over an unpolished design in total knee arthroplasty with the goal of reducing PE wear by means of providing a smoother backside countersurface for the UHMWPE component.
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Affiliation(s)
- Richard J Holleyman
- Newcastle Upon Tyne Hospitals Trust, Royal Victoria Infirmary & Freeman Hospital, Newcastle upon Tyne, NE1 4LP, UK.
- Newcastle University, Newcastle upon Tyne, UK.
| | | | - David Weir
- Newcastle Upon Tyne Hospitals Trust, Royal Victoria Infirmary & Freeman Hospital, Newcastle upon Tyne, NE1 4LP, UK
| | | | - Jim Holland
- Newcastle Upon Tyne Hospitals Trust, Royal Victoria Infirmary & Freeman Hospital, Newcastle upon Tyne, NE1 4LP, UK
| | - Tom J Joyce
- Newcastle University, Newcastle upon Tyne, UK
| | - David J Deehan
- Newcastle Upon Tyne Hospitals Trust, Royal Victoria Infirmary & Freeman Hospital, Newcastle upon Tyne, NE1 4LP, UK
- Newcastle University, Newcastle upon Tyne, UK
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Teeter MG, Lanting BA, Shrestha KR, Howard JL, Vasarhelyi EM. Contribution of Surface Polishing and Sterilization Method to Backside Wear in Total Knee Arthroplasty. J Arthroplasty 2015; 30:2320-2. [PMID: 26182981 DOI: 10.1016/j.arth.2015.06.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/09/2015] [Accepted: 06/17/2015] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to compare the relative contributions of backside wear from polished and roughened tibial baseplates and different sterilization methods. Three groups of tibial inserts of the same design were matched: roughened gamma-air (RGA), polished gamma-air (PGA), and polished gas-plasma (PGP). Visual damage scoring and micro-CT deviation maps were used for evaluation. Total backside damage was higher (P=0.045) in RGA (13.8±3.4) compared to PGA (8.7±3.4) and PGP (8.2±4.8). Backside wear rates were greatest (P=0.02) in RGA (0.038 mm/year), followed by PGA (0.012 mm/year), and lowest in PGP (0.009 mm/year). Use of a roughened tibial baseplate had a greater effect on wear magnitude than sterilization method.
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Affiliation(s)
- Matthew G Teeter
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Surgical Innovation Program, Lawson Health Research Institute, London, Ontario, Canada
| | - Brent A Lanting
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Kush R Shrestha
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - James L Howard
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Edward M Vasarhelyi
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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