Summary
The degree of conformity and constraint are thought to play an important role in the severity of wear damage of the polyethylene insert of total knee replacement (TKR). Wear is thought to diminish as a function of increasing conformity and hence increased surface areas and thus diminished contact stresses. However, a study of retrieved polyethylene components of less conforming CR prostheses (MG2) and more conforming PS and CCK devices (IBII) showed more severe wear damage (delamination and pitting) on the articulating surfaces of the more conforming design. In addition, the IB2 post showed substantial wear-related damage, implicating it as an important source of particulate debris. Wear in TKR is a complex phenomenon influenced by many variables beyond the simple relationship between conformity and surface area.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Sharkey PF et al (2002) Insall Award paper. Why are total knee arthroplasties failing today? Clin Orthop 404:7–13
Huang CH et al (2002) Osteolysis in failed total knee arthroplasty: a comparison of mobile-bearing and fixed-bearing knees. J Bone Joint Surg [Am] 84:2224–2229
Hood RW et al (1983) Retrieval analysis of total knee prostheses: a method and its application to 48 total condylar prostheses. J Biomed Mater Res 17:829–842
Eyerer P (1986) Kunststoffe in der Gelenkendoprothetik. Z Werkstofftechnik 17:284
Furman B et al (1997) Effect of resin type and manufacturing method on UHMWPE oxidation and quality at long aging and implant times. Trans of 43rd Annual Meeting of the Orthopaedic Research Society
Lewis G (1997) Polyethylene wear in total hip and knee arthroplasties. J Biomed Mater Res 38:55–75
Schmidt MB, Hamilton JV (1996) The effects of calcium stearate on the properties of UHMWPE. Trans of 42nd Annual Meeting of the Orthopedic Research Society 21:239
Berzins A et al (2002) Surface damage in machined ram-extruded and net-shape molded retrieved polyethylene tibial inserts of total knee replacements. J Bone Joint Surg [Am] 84:1534–1540
Banks SA et al (1997) Total knee replacement mechanics during gait. Trans of 43rd Annual Meeting of the Orthopedic Research Society 22:263
Bertin KC et al (2002) In vivo determination of posterior femoral rollback for subjects having a NexGen posterior cruciate-retaining total knee arthroplasty. J Arthroplasty 17:1040–1048
Li G et al (2001) Cruciate-retaining and cruciate-substituting total knee arthroplasty: an in vitro comparison of the kinematics under muscle loads. J Arthroplasty 16[Suppl 1]:150–156
Andriacchi TP, Galante JO (1988) Retention of the posterior cruciate in total knee arthroplasty. J Arthroplasty 3[Suppl]:S13–19
Bartel DL et al (1995) Stresses in polyethylene components of contemporary total knee replacements. Clin Orthop 317:76–82
Haman JD, Wimmer MA (2003) Tibial plateau damage in retrieved conforming and non-conforming TKAs. Proc Annual Meeting of Society for Biomaterials 25:383
Haman JD, Wimmer MA (2003) Tibial post damage in TKAs is associated with tibial plateau damage. Trans of 49th Annual Meeting of the Orthopedic Research Society 28:6
Collier JP et al (1991) Analysis of the failure of 122 polyethylene inserts from uncemented tibial knee components. Clin Orthop 273:232–242
Feng EL et al (1994) Progressive subluxation and polyethylene wear in total knee replacements with flat articular surfaces. Clin Orthop 299:60–71
Blunn GW et al (1992) Polyethylene wear in unicondylar knee prostheses. 106 retrieved Marmor, PCA, and St. Georg tibial components compared. Acta Orthop Scand 63:247–255
Ritter MA et al (1995) Flat-on-flat, nonconstrained, compression molded polyethylene total knee replacement. Clin Orthop 321:79–85
Mazzucco D, Spector M (2003) Effect of contact area on the wear of ultrahigh molecular weight polyethylene in bidirectional pin-on-flat articulation. Trans of 49th Annual Meeting of the Orthopedic Research Society 28:1
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Springer Medizin Verlag Heidelberg
About this chapter
Cite this chapter
Haman, J.D., Wimmer, M.A., Galante, J.O. (2005). Surface Damage and Wear in Fixed, Modular Tibial Inserts: The Effects of Conformity and Constraint. In: Bellemans, J., Ries, M.D., Victor, J.M. (eds) Total Knee Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-27658-0_13
Download citation
DOI: https://doi.org/10.1007/3-540-27658-0_13
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-20242-4
Online ISBN: 978-3-540-27658-6
eBook Packages: MedicineMedicine (R0)