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Characterization of In Vivo Damage on Retrieved Total Shoulder Glenoid Liners. LUBRICANTS 2022. [DOI: 10.3390/lubricants10080166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
An attempt was made to retrieve glenoid liners from revision surgery to undertake a retrospective study to measure the resulting in vivo damage. Since the glenoid liners are circumferential, the curvature changes at every point in the component, an “assisting arm” was designed to hold the liner firmly, thus allowing accurate microscopic measurements. We characterized the damage in terms of pitting, embedded debris, complete fracture, abrasion, deformation, delamination, burnishing, grooving, and scratching that took place mutually exclusively. This study of 26 liners showed embedded debris was the most underrated damage mode found on the liners, followed by pitting and abrasion, representing 65.2% and 52.2% of the liners, respectively. The prevalence of pitting in over half the samples examined is indicative of free-radical oxidation, resulting in a decrease in physical strength from morphological changes in the microstructure. These may initiate from different pathways, however, they may interact with other processes in which other damage initiates and grows, resulting in higher damage causing premature failure due to wear. A probabilistic approach was developed to generate survival time for these liners and may provide a statistical removal time of the glenoid liners in the future.
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Mohammad HR, Campi S, Kennedy JA, Judge A, Murray DW, Mellon SJ. Long-term in vivo wear of different bearing types used for the Oxford Unicompartmental Knee Replacement. Bone Joint Res 2019; 8:535-543. [PMID: 31832173 PMCID: PMC6888733 DOI: 10.1302/2046-3758.811.bjr-2019-0163.r1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives The aim of this study was to determine the polyethylene wear rate of Phase 3 Oxford Unicompartmental Knee Replacement bearings and to investigate the effects of resin type and manufacturing process. Methods A total of 63 patients with at least ten years’ follow-up with three bearing types (1900 resin machined, 1050 resin machined, and 1050 resin moulded) were recruited. Patients underwent full weight-bearing model-based radiostereometric analysis to determine the bearing thickness. The linear wear rate was estimated from the change in thickness divided by the duration of implantation. Results The wear rate for 1900 resin machined (n = 19), 1050 machined (n = 21), and 1050 moulded bearings (n = 23) were 60 µm/year (sd 42), 76 µm/year (sd 32), and 57 µm/year (sd 30), respectively. There was no significant difference between 1900 machined and 1050 machined (p = 0.20), but 1050 moulded had significantly less wear than the 1050 machined (p = 0.05). Increasing femoral (p < 0.001) and tibial (p < 0.001) component size were associated with increasing wear. Conclusion Wear rate is similar with 1050 and 1900 resin, but lower with moulded bearings than machined bearings. The currently used Phase 3 bearings wear rate is low (1050 moulded, 57 µm/year), but higher than the previously reported Phase 2 bearings (1900 moulded, 20 µm/year). This is unlikely to be due to the change in polyethylene but may relate to the minimally invasive approach used with the Phase 3. This approach, as well as improving function and thus increasing activity levels, may increase the risk of surgical errors, such as impingement or bearing overhang, which can increase wear. Surgeons should aim to use 4 mm thick bearings rather than 3 mm thick bearings in young patients, unless they are small and need conservative bone resections. Cite this article: Bone Joint Res 2019;8:535–543.
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Affiliation(s)
- Hasan R Mohammad
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Oxford University Hospitals. Nuffield Orthopaedic Centre, Oxford, UK
| | - Stefano Campi
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Oxford University Hospitals. Nuffield Orthopaedic Centre, Oxford, UK
| | - James A Kennedy
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Oxford University Hospitals. Nuffield Orthopaedic Centre, Oxford, UK
| | - Andrew Judge
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK; Director MSc Orthopaedic Surgery, University of Bristol; Honorary Professor, Centre for Statistics in Medicine, University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - David W Murray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Oxford University Hospitals. Nuffield Orthopaedic Centre, Oxford, UK
| | - Stephen J Mellon
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Yan Y, Chen H, Feng J, Chen K, Zhou K, Hong W, Wang Y, Liu Z, Zhang J, Yang Q, Guo L, He C. Poor performance of Enduron polyethylene liner in total hip arthroplasty: a minimum ten-year follow up and ultra-morphological analysis of wear particles. INTERNATIONAL ORTHOPAEDICS 2016; 41:723-730. [PMID: 27178441 DOI: 10.1007/s00264-016-3217-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 04/25/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of the present study was to investigate the long-term outcome and the wear characteristics of two distinct types of ultra-high molecular weight polyethylene (UHMWPE) liners in total hip arthroplasty (THA). METHODS We conducted a retrospective clinical study on patients which were treated with total hip arthroplasty using either Enduron polyethylene (Enduron PE) or Trilogy polyethylene (Trilogy PE) liners based on a minimum of ten year follow up data. Morphological analyses of wear particles from tissue samples, which were harvested during revision surgeries, were also performed. RESULTS A total of 79 THAs in the Enduron group and 55 THAs in the Trilogy group were available for analysis. Kaplan-Meier survival with revision for wear-related complications as the endpoint of the Enduron PE liners was lower than that of Trilogy PE liners at ten years (93.5 % and 100 %, P = 0.03). The Enduron group had higher mean linear wear rate than that of the Trilogy group (0.20 ± 0.09 and 0.09 ± 0.03 mm/year, P < 0.01). The incidence of osteolysis for the Enduron group was higher than that of the Trilogy group (33.3 % and 12 %, P = 0.04). Under transmission electron microscopy, the Enduron group had more than 82 % of the particles less than 1.0 μm in size and more than 57 % of the particles less than 0.5 μm. CONCLUSION The long-term performance of Enduron liners was worse than that of Trilogy liners. Further clinical follow-up may be necessary in patients with Enduron PE liners in order to avoid catastrophic complications.
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Affiliation(s)
- Yufei Yan
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China.,Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Hao Chen
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China.,Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Jianmin Feng
- Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Kaizhe Chen
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China.,Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Kaidi Zhou
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China.,Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Weixiang Hong
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China.,Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Yi Wang
- Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Zhihong Liu
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China.,Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Jiong Zhang
- Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Qingming Yang
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China.,Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
| | - Lei Guo
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China. .,Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
| | - Chuan He
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China. .,Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China.
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