Backsurface Wear and Deformation in Polyethylene Tibial Inserts Retrieved Postmortem

Surace, Michele Francesco; Berzins, Aivars; Urban, Robert M.; Jacobs, Joshua J.; Berger, Richard A.; Natarajan, Raghu N.; Andriacchi, Thomas P.; Galante, Jorge O.

doi:10.1097/00003086-200211000-00004

Cited by 39 publications

(23 citation statements)

References 15 publications

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“…Backside wear retrieval studies of tibial components have reported burnishing, pitting, and polyethylene protrusion into the tray's screw holes (Conditt et al, 2004b;Cuckler et al, 2003;Engh et al, 2001;Parks et al, 1998;Rao et al, 2002;Surace et al, 2002). Our findings are consistent with this in that burnishing was the prevalent mode of polyethylene damage, especially when fretted against rougher surfaces.…”

Section: Discussionsupporting

confidence: 87%

“…However, the relative influences of metal surface roughness, alloy, and micromotion on fretting wear have not been systematically studied. Rather, most studies have used retrieved implants, scoring damage on the inferior surface (Engh et al, 2001;Harman et al, 2007;Rao et al, 2002;Surace et al, 2002;Wasielewski et al, 1997), measuring polyethylene extrusion from inferior insert surfaces into tibial tray screw holes (Conditt et al, 2005), or measuring decreases in depths of manufacturer's stamped markings on the inferior polyethylene surface (Crowninshield et al, 2006). Although these studies provide valuable information, they are indirect retrospective measurements.…”

Section: Introductionmentioning

confidence: 99%

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Material and surface factors influencing backside fretting wear in total knee replacement tibial components

Billi

Sangiorgio

Aust

et al. 2010

Journal of Biomechanics

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Material and surface factors influencing backside fretting wear in total knee replacement tibial components

Billi

Sangiorgio

Aust

et al. 2010

Journal of Biomechanics

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“…Despite the fact that the neocapsule is not responsible for loosening, it can give useful diagnostic information. Several studies have shown that the new joint space interacts with the periprosthetic space, [21][22][23] and it is generally accepted that the changes in histological appearance are very similar in these different tissue specimens in the same patient. 13 17 The periprosthetic membrane is marked by a heterogeneous appearance in histopathology.…”

mentioning

confidence: 99%

Proposal for a histopathological consensus classification of the periprosthetic interface membrane

2006

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Aims:The introduction of clearly defined histopathological criteria for a standardised evaluation of the periprosthetic membrane, which can appear in cases of total joint arthroplasty revision surgery.Methods:Based on histomorphological criteria, four types of periprosthetic membrane were defined: wear particle induced type (detection of foreign body particles; macrophages and multinucleated giant cells occupy at least 20% of the area; type I); infectious type (granulation tissue with neutrophilic granulocytes, plasma cells and few, if any, wear particles; type II); combined type (aspects of type I and type II occur simultaneously; type III); and indeterminate type (neither criteria for type I nor type II are fulfilled; type IV). The periprosthetic membranes of 370 patients (217 women, 153 men; mean age 67.6 years, mean period until revision surgery 7.4 years) were analysed according to the defined criteria.Results:Frequency of histopathological membrane types was: type I 54.3%, type II 19.7%, type III 5.4%, type IV 15.4%, and not assessable 5.1%. The mean period between primary arthroplasty and revision surgery was 10.1 years for type I, 3.2 years for type II, 4.5 years for type III and 5.4 years for type IV. The correlation between histopathological and microbiological diagnosis was high (89.7%), and the inter-observer reproducibility sufficient (85%).Conclusion:The classification proposed enables standardised typing of periprosthetic membranes and may serve as a tool for further research on the pathogenesis of the loosening of total joint replacement. The study highlights the importance of non-infectious, non-particle induced loosening of prosthetic devices in orthopaedic surgery (membrane type IV), which was observed in 15.4% of patients.

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“…Analysis of backside wear of tibial inserts suggested that the majority of wear from knee implants comes from the backside. 16,24 Storing the retrieved implants provides an invaluable resource for research and analysis. In a recent study, the records of 26 patients (27 knees) who sustained a fracture of a total condylar design total knee prosthesis revealed 25 fractures involving the tibial component and two fractures involving the femoral component.…”

Section: Discussionmentioning

confidence: 99%

Orthopedic Implant Retrieval—Imperatives and Possibilities

Yeakley

Goswami

2009

Ann Biomed Eng

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Premature orthopedic implant failure occurs for a variety of reasons. In such scenarios implant retrieval is an issue that has a potential for further investigation leading to redesign of components and to improve implant longevity. While strict standards must be adhered to in order to gain FDA approval to use an implant, capturing, and recording the contributing factors leading to explantation and that of retrieved implant is neither strictly adhered to nor enforced. This article presents data illustrating implant standards both pre-market approval as well as in the retrieval scenarios. This paper provides a compilation of specific specifications on implant retrieval handling and storage, compelling imperatives and possibilities at national or global scale. The need for a user-definable, searchable interface is proposed in this paper to facilitate such an important task.

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Backsurface Wear and Deformation in Polyethylene Tibial Inserts Retrieved Postmortem

Cited by 39 publications

References 15 publications

Material and surface factors influencing backside fretting wear in total knee replacement tibial components

Material and surface factors influencing backside fretting wear in total knee replacement tibial components

Proposal for a histopathological consensus classification of the periprosthetic interface membrane

Orthopedic Implant Retrieval—Imperatives and Possibilities

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