Optical analysis of surface changes on early retrievals of highly cross-linked and conventional polyethylene tibial inserts

Muratoglu, Orhun K.; Ruberti, Jeff; Melotti, S.A.; Spiegelberg, Stephen H.; Greenbaum, Evan S.; Harris, William H.

doi:10.1016/s0883-5403(03)00293-6

Cited by 76 publications

(64 citation statements)

References 10 publications

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“…The overall severity of backside polyethylene wear was graded by direct visual analysis during blinded (BSE) inspection. Grades were assigned based on the overall severity of wear as negligible (0), mild (1), moderate (2), and severe (3) [10,20,25,36]. Using the six zones, the area of polyethylene wear was then graded as negligible (0), less than 10% (1), between 10% and 50% (2), or greater than 50% (3) [14,29,36].…”

Section: Methodsmentioning

confidence: 99%

“…Using the six zones, the area of polyethylene wear was then graded as negligible (0), less than 10% (1), between 10% and 50% (2), or greater than 50% (3) [14,29,36]. The depth of the major wear defect was then graded as less than 500 lm (1), between 500 lm and 1 mm (2), or greater than 1 mm (3) [8,9,25]. Depth measurements were obtained using stereomicroscopy and scanning electron microscopy for Fig.…”

Section: Methodsmentioning

confidence: 99%

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Polyethylene Wear Is Influenced by Manufacturing Technique in Modular TKA

Lombardi

Ellison

Berend

2008

Clinical Orthopaedics &Amp; Related Research

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Polyethylene insert backside surface wear is implicated in osteolysis and failure of total knee arthroplasty. Manufacturing and sterilization methods reduce articular-sided wear. We questioned whether manufacturing technique influences the severity of backside wear. We examined 39 explanted tibial bearings in a blinded fashion using visual, stereomicroscopic, and scanning electron microscopic techniques. We examined 26 direct compression molded components and 13 nondirect compression molded components and applied a new backside wear severity score. The score characterized the magnitude of the various modes of wear with severity ranging from 0 (no wear) to 27 (severe wear). Time in vivo, tibial baseplate material, and manufacturing technique were used as variables for comparison. Backside wear was related to polyethylene manufacturing process with direct compression molded implants having a wear score of 2.3 and nondirect compression molded a score of 5.7. Time in vivo influenced backside wear, although direct compression molded predicted decreased backside wear independent of time in vivo. The data suggest manufacturing technique influences backside wear in total knee arthroplasty polyethylene inserts.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Polyethylene Wear Is Influenced by Manufacturing Technique in Modular TKA

Lombardi

Ellison

Berend

2008

Clinical Orthopaedics &Amp; Related Research

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“…By virtue of the shape memory effect, UHMWPE and HXLPE heated to high enough temperature recover the original shape that has been previously lost due to mechanical deformation [29]. The recovery of plastic deformation after wear testing was achieved by heating samples at 120 °C for 36 hours.…”

Section: Wear Experimentsmentioning

confidence: 99%

Improved wear performance of ultra high molecular weight polyethylene coated with hydrogenated diamond like carbon

Puértolas

Martínez-Nogués

Martínez-Morlanes

et al. 2010

Wear

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“…Evaluation of surface damage and oxidative properties of retrieved XLPE TKA tibial components from revision surgeries showed little improvement with the use of XLPE [20,27]. The first retrieval analysis of XLPE tibial inserts used an optical grading method to analyze surface damage and found no differences between eight XLPE tibial inserts and 71 conventional PE inserts [23]. However, a major limitation of these retrieval studies is the lack of controlled conditions across study groups.…”

Section: Introductionmentioning

confidence: 99%

Surface Damage Is Not Reduced With Highly Crosslinked Polyethylene Tibial Inserts at Short-term

Liu

Esposito

Elpers

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Highly crosslinked ultrahigh-molecularweight polyethylene (XLPE) has been shown to reduce wear in hip arthroplasty, but the advantages over conventional polyethylene (PE) in total knee arthroplasty (TKA), if any, remain unclear. Questions/purposes Do differences exist in (1) surface damage as measured by damage score and percent area affected; and (2) extent and location of dimensional changes between XLPE and conventional PE observed on retrieved TKA tibial inserts?Methods In this study of components retrieved at the time of revision surgery, we matched 44 XLPE to 44 conventional PE inserts from four manufacturers; the matching approach considered implant design (exact match), insert size (exact match), and length of implantation (matched ± 6 months). Surface damage on the articular surfaces was subjectively graded and digitally mapped to determine the percent damaged area of each damage mode. Three-dimensional changes that had occurred as a result of implantation were determined by comparing laser scans of the retrieved inserts with size-matched pristine inserts. Results The differences of damage scores and percent damaged areas between the matched XLPE and conventional PE inserts were not large enough to be clinically significant with low corresponding levels of statistical significance (scores: 42 ± 13; 95% confidence interval [CI], 38-46 versus 45 ± 13; 95% CI, 41-49; p = 0.4; percent areas: 54% ± 38%; 95% CI, 44%-64% versus 54% ± 32%; 95% CI, 42%-65%; p = 0.9). However, XLPE inserts showed greater articular surface dimensional changes with high significance (root mean square of the distance: 0.16 ± 0.06 mm; 95% CI, 0.13-0.18 mm versus 0.14 ± 0.05 mm; 95% CI, 0.11-0.16 mm; p = 0.03). Within the same design, deviation patterns were consistent between the two materials; however, as expected, the location of the dimensional changes differed among designs: the negative deviations on the plateaus were centrally located in Zimmer PS inserts, were located on the perimeter in Smith & Nephew PS inserts, and were across the entire surface in DePuy PS inserts.

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Optical analysis of surface changes on early retrievals of highly cross-linked and conventional polyethylene tibial inserts

Cited by 76 publications

References 10 publications

Polyethylene Wear Is Influenced by Manufacturing Technique in Modular TKA

Polyethylene Wear Is Influenced by Manufacturing Technique in Modular TKA

Improved wear performance of ultra high molecular weight polyethylene coated with hydrogenated diamond like carbon

Surface Damage Is Not Reduced With Highly Crosslinked Polyethylene Tibial Inserts at Short-term

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