Relationship of surface damage appearance and volumetric wear in retrieved TKR polyethylene liners

Knowlton, Christopher; Bhutani, P; Wimmer, Markus A.

doi:10.1002/jbm.b.33684

Cited by 21 publications

(23 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The polished baseplate design with a tongue-in-groove locking mechanism (AMK) also showed less linear wear than the nonpolished Scorpio. While backside two-dimensional visual total damage scores and three-dimensional micro-CT linear wear rates were positively correlated in our study, this finding has not necessarily been the case in previous analyses [23,40]. The results shown by the Scorpio retrievals concur with those of other studies that analyzed the influence of baseplate roughness on backside wear.…”

Section: Discussionsupporting

confidence: 79%

Current Total Knee Designs: Does Baseplate Roughness or Locking Mechanism Design Affect Polyethylene Backside Wear?

Sisko

Teeter

Lanting

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 79%

Current Total Knee Designs: Does Baseplate Roughness or Locking Mechanism Design Affect Polyethylene Backside Wear?

Sisko

Teeter

Lanting

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Secondly, the Hood score is a semi-quantitative score used to assess surface damage, which was recently proved to be only a moderate predictor of material volume loss [31]. However, the significant higher surface damage found in the backside of the Attune fixed design should be monitored.…”

Section: This Is the First Retrieval Study Comparing Surface Damage Amentioning

confidence: 99%

Retrieval analysis of contemporary antioxidant polyethylene: multiple material and design changes may decrease implant performance

Cerquiglini

Henckel

Hothi

et al. 2019

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Background With the introduction of the Attune Knee System (DePuy) in March 2013 a new polyethylene formulation incorporating anti-oxidants was used. Although several in vitro studies have demonstrated the positive effects of antioxidants on UHMWPE, no retrieval study has looked at polyethylene damage of this system yet. It was the aim of this study to investigate the in vivo performance of this new design, by comparing it with its predecessors in retrieval analysis. Methods Twenty-four PFC (18 fixed bearing and 6 rotating platform designs) and 17 Attune (8 fixed bearing and 9 rotating platform designs) implants were retrieved. For retrieval analysis a macroscopic analysis of polyethylene components, using a peer-reviewed damage grading method was used. Medio-lateral polyethylene thickness difference was measured with a peerreviewed micro-CT based method. The roughness of metal components was measured. All findings were compared between the two designs. Results Attune tibial inserts with fixed bearings showed significantly higher hood scores on the backside surface when compared with their PFC counterparts (p=0.0150), no other significant differences were found in the polyethylene damage of all the other surfaces analysed, in the surface roughness of metal components and in medio-lateral linear deformations. Conclusion A significant difference between PFC and Attune fixed bearing designs were found in terms of backside surface damage: multiple changes in material and design features could lead to a potential decrease of implant performance. Our results may help to understand how the new Attune Knee System performs in vivo.

show abstract

“…This discrepancy might be caused by the subjective nature of the widely used Hood score. Indeed, surface damage was found to be only a moderate predictor of wear in polyethylene [ 33 ]. Moreover, our components were revised relatively early with median time to revision of 37 months (5–162).…”

Section: Discussionmentioning

confidence: 99%

3D patient imaging and retrieval analysis help understand the clinical importance of rotation in knee replacements

Cerquiglini

Henckel

Hothi

et al. 2018

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeThe purpose of the present study was to correlate highly accurate CT measurements of pre-revision total knee arthroplasty (TKA) implant position with findings of retrieval analysis post-revision, to understand the clinical relevance of TKA orientation.MethodsThis study involved 53 retrieved TKA implants with pre-revision 3D-CT scans used to determine coronal (varus–valgus), sagittal (tibial slope) and rotational (internal rotation–external rotation) TKA orientation as well as tibiofemoral leg axis. Differences between femoral and tibial angles to describe the "relative rotational mismatch" were also calculated. All tibial inserts were forensically analyzed using the Hood score. Statistical analysis was performed to investigate correlations between TKA component orientation and surface damage (p < 0.05).ResultsFemoral components were found to have axial rotations mainly within ± 3° (68%), whilst 45% of the tibial components and 66% of the relative rotational mismatches were > 3° and < − 3°, respectively. The majority of femoral and tibial components (87% in both cases), as well as the femorotibial angle (70%), showed coronal orientations within ± 3°. The 64% of the tibial components showed posterior tibial slopes out of both the 0°–3° and 5°–7° ranges. There was a significant correlation between tibial slope and damage score on polyethylene tibial inserts (r = 0.2856; p = 0.0382) as well as a significant correlation between implants’ position in the axial plane and damage score on polyethylene tibial inserts (r = 0.6537, p = 0.0240).ConclusionsThis is the first study to use accurate measurements from pre-revision 3DCT to compare tibial and femoral orientation in all three planes with retrieval findings in total knee replacements. A significant correlation between implant position and polyethylene surface damage was found. These results showed the importance of optimizing component position to minimize polyethylene damage. Further analysis involving more accurate polyethylene wear measurements are fundamental to fully understand the role of components’ orientation in TKAs.

show abstract

Relationship of surface damage appearance and volumetric wear in retrieved TKR polyethylene liners

Cited by 21 publications

References 36 publications

Current Total Knee Designs: Does Baseplate Roughness or Locking Mechanism Design Affect Polyethylene Backside Wear?

Current Total Knee Designs: Does Baseplate Roughness or Locking Mechanism Design Affect Polyethylene Backside Wear?

Retrieval analysis of contemporary antioxidant polyethylene: multiple material and design changes may decrease implant performance

3D patient imaging and retrieval analysis help understand the clinical importance of rotation in knee replacements

Contact Info

Product

Resources

About