The influence of third-body particles on wear rate in unicondylar knee arthroplasty: a wear simulator study with bone and cement debris

Schroeder, Christian; Grupp, Thomas M.; Fritz, Bernhard; Schilling, Christoph; Yan, Cheng; Utzschneider, Sandra; Jansson, Volkmar

doi:10.1007/s10856-013-4883-8

Cited by 21 publications

(38 citation statements)

References 20 publications

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“…Retrieval studies have shown a relation between third-body particles, increased roughness of the femoral condyles, and increased polyethylene wear [ 32 , 33 ]. This has also been confirmed by in vitro wear studies that determined increased polyethylene wear in the presence of cement particles in knee joint replacements [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 62%

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Wear Performance of Calcium Carbonate-Containing Knee Spacers

et al. 2017

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Articulating spacers should be wear-resistant and load-bearing to avoid prolonged immobilization of the patient and to reduce morbidity. However, due to the articulation of both components, a release of cement wear particles is to be expected. The aim of this study was to investigate the wear performance of a new spacer cement that contains calcium carbonate as a radio-opaque substance, in comparison to an established barium sulphate-containing spacer material, and also to characterize the amount, morphology, and size distributions of the released cement particles in detail. Force-controlled simulation was carried out on an AMTI knee simulator. The test parameters were in accordance with the standard ISO 14243-1 with a 50% reduced axial force. Tests were run for 500,000 cycles at a frequency of 1 Hz. For wear analysis, photographic documentation of the wear scars, gravimetric wear measurements and wear particle analysis were performed. The barium sulphate spacer material showed a total articular wear of 375.53 ± 161.22 mg. For the calcium carbonate-containing cement, reduced articular wear of 136.32 ± 37.58 mg was determined. Isolated cement wear particles of the barium sulphate-containing cement had a diameter of 0.429 ± 0.224 μm and were significantly larger compared to the calcium carbonate-containing cement (0.380 ± 0.216 μm, p = 0.02). The calcium carbonate-containing cement showed better wear performance in terms of gravimetric wear and particle release. Thus, calcium carbonate seems to be a promising material as a radio-opaque substrate in cement spacers.

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Section: Discussionmentioning

confidence: 62%

“…Therefore, it is expected that cement particles may also contribute to the wear performance of the final joint replacement. As third-body wear particles, they are able to accelerate wear processes, particularly when radio-opaque substances such as barium sulphate or zirconium dioxide are involved [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Wear Performance of Calcium Carbonate-Containing Knee Spacers

et al. 2017

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“…In the knee wear simulator it is necessary to test both condyles, so we therefore chose the same implant on the lateral side to create a placeholder during testing. This technique has also been established by other groups [ 14 , 15 , 25 , 27 ].…”

Section: Discussionmentioning

confidence: 97%

Increase in the Tibial Slope Reduces Wear after Medial Unicompartmental Fixed-Bearing Arthroplasty of the Knee

Weber

Schröder

Schwiesau³

et al. 2015

BioMed Research International

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Introduction. Unicompartmental arthroplasty of the knee in patients with isolated medial osteoarthritis gives good results, but survival is inferior to that of total knee prosthesis. Knees may fail because positioning of the prosthesis has been suboptimal. The aim of this study was to investigate the influence of the tibial slope on the rate of wear of a medial fixed-bearing unicompartmental knee arthroplasty. Materials and Methods. We simulated wear on a medial fixed-bearing unicompartmental knee prosthesis (Univation) in vitro with a customised, four-station, and servohydraulic knee wear simulator, which exactly reproduced the walking cycle (International Organisation for Standardisation (ISO) 14243-1:2002(E)). The medial prostheses were inserted with 3 different posterior tibial slopes: 0°, 4°, and 8° (n = 3 in each group). Results. The wear rate decreased significantly between 0° and 4° slope from 10.4 (SD 0.62) mg/million cycles to 3.22 (SD 1.71) mg/million cycles. Increasing the tibial slope to 8° did not significantly change the wear rate. Discussion. As an increase in the tibial slope reduced the wear rate in a fixed-bearing prosthesis, a higher tibial slope should be recommended. However, other factors that are influenced by the tibial slope (e.g., the tension of the ligament) must also be considered.

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“…The cohesion between the tissues and pure ceramics is also lower than the cohesion of autografts, which might cause particles to spread around the surgical field during implantation [35,36]. Grafting near the joints might cause loose particles to migrate between joint surfaces, and thus create third-body wear [37]. In our study, the new β-TCP/PLCL scaffold was easily moldable and adaptable to the anatomical convex contour of the skull, even though the ceramic concentration of the scaffold was 50 weight-%.…”

Section: Discussionmentioning

confidence: 99%

Novel osteoconductive β-tricalcium phosphate/poly(L-lactide-co-e-caprolactone) scaffold for bone regeneration: a study in a rabbit calvarial defect

Pihlman

Keränen

Paakinaho

et al. 2018

J Mater Sci: Mater Med

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The advantages of synthetic bone graft substitutes over autogenous bone grafts include abundant graft volume, lack of complications related to the graft harvesting, and shorter operation and recovery times for the patient. We studied a new synthetic supercritical CO2-processed porous composite scaffold of β-tricalcium phosphate and poly(L-lactide-cocaprolactone) copolymer as a bone graft substitute in a rabbit calvarial defect. Bilateral 12 mm diameter critical size calvarial defects were successfully created in 18 rabbits. The right defect was filled with a scaffold moistened with bone marrow aspirate, and the other was an empty control. The material was assessed for applicability during surgery. The follow-up times were 4, 12, and 24 weeks. Radiographic and micro-CT studies and histopathological analysis were used to evaluate new bone formation, tissue ingrowth, and biocompatibility. The scaffold was easy to shape and handle during the surgery, and the bone-scaffold contact was tight when visually evaluated after the implantation. The material showed good biocompatibility and its porosity enabled rapid invasion of vasculature and full thickness mesenchymal tissue ingrowth already at four weeks. By 24 weeks, full thickness bone ingrowth within the scaffold and along the dura was generally seen. In contrast, the empty defect had only a thin layer of new bone at 24 weeks. The radiodensity of the material was similar to the density of the intact bone. In conclusion, the new porous scaffold material, composed of microgranular β-TCP bound into the polymer matrix, proved to be a promising osteoconductive bone graft substitute with excellent handling properties.

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The influence of third-body particles on wear rate in unicondylar knee arthroplasty: a wear simulator study with bone and cement debris

Cited by 21 publications

References 20 publications

Wear Performance of Calcium Carbonate-Containing Knee Spacers

Wear Performance of Calcium Carbonate-Containing Knee Spacers

Increase in the Tibial Slope Reduces Wear after Medial Unicompartmental Fixed-Bearing Arthroplasty of the Knee

Novel osteoconductive β-tricalcium phosphate/poly(L-lactide-co-e-caprolactone) scaffold for bone regeneration: a study in a rabbit calvarial defect

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