Biotribology of a new bearing material combination in a rotating hinge knee articulation

Grupp, Thomas M.; Giurea, Alexander; Miehlke, R. K.; Hintner, Martin; Gaisser, M.; Schilling, Christoph; Schwiesau, Jens; Kaddick, Christian

doi:10.1016/j.actbio.2013.02.030

Cited by 44 publications

(28 citation statements)

References 53 publications

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“…Biotribologic studies have shown in vitro promising low rates of wear and debris for the EnduRo prosthesis [17]. We were interested if these findings will correlate in clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

“…The axis is not primarily weight bearing but provides stability of the joint in case of severe coronal or sagittal instability. The axes are embedded in bushings and flanges made of PEEK-Optima LT1 (Invibio Ltd., Thornton-Cleveleys, UK) with a carbon-fiber reinforcement containing 30% polyacrylonitrile- (PAN-) based carbon fibers (CFR-PEEK LT1 CA 30) firstly used as a bearing articulation in TKA in order to minimize wear and creep [17, 19]. The prosthesis is designed for a ROM from 3° of hyperextension to 135° of flexion.…”

Section: Methodsmentioning

confidence: 99%

“…In order to address certain anatomical situations it offers an offset option and wedges for the tibial and the femoral components. Additionally, it contains carbon-fibre reinforced poly-ether-ether-ketone (CRF-PEEK) flanges and bushings firstly used as a bearing material in TKA [17]. Biotribological in vitro studies showed decreased wear for this implant [17].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, it contains carbon-fibre reinforced poly-ether-ether-ketone (CRF-PEEK) flanges and bushings firstly used as a bearing material in TKA [17]. Biotribological in vitro studies showed decreased wear for this implant [17]. Furthermore an in vivo murine model showed similiar biological response to CFR-PEEK, if compared to polyethylene debris particles [18].…”

Section: Introductionmentioning

confidence: 99%

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Early Results of a New Rotating Hinge Knee Implant

Giurea

Neuhaus

Miehlke³

et al. 2014

BioMed Research International

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Background. Indication for rotating hinge (RH) total knee arthroplasty (TKA) includes primary and revision cases, with contradictory results. The aim of this study was to report prospective early results of a new modular rotating hinge TKA (EnduRo). For this implant several new design features and a new bearing material (carbon-fiber reinforced poly-ether-ether-ketone) have been developed. Furthermore, we tried to establish a new classification of failure modes for revision TKA. Methods. 152 EnduRo rotating-hinge prostheses were implanted in two centers. In 90 patients a primary implantation has been performed and 62 patients were revision cases. Knee Society Score (KSS), Western Ontario and McMaster Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), and Range of motion (ROM) were assessed before surgery, 3 months postoperatively, 12 months postoperatively, and annually thereafter. We defined 3 types of complications: Type 1, infection; type 2, periprosthetic complications; type 3, implant failures. Results. KSS, WOMAC, OKS, and ROM revealed significant improvements between the preoperative and the follow-up investigations. There were 14 complications (9.2%) leading to revision surgery, predominantly type 2. Conclusion. Our study shows excellent clinical results of the EnduRo TKA. Furthermore, no premature material failure or unusual biological response to the new bearing material could be detected.

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“…Biotribologic studies have shown in vitro promising low rates of wear and debris for the EnduRo prosthesis [17]. We were interested if these findings will correlate in clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Early Results of a New Rotating Hinge Knee Implant

Giurea

Neuhaus

Miehlke³

et al. 2014

BioMed Research International

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“…However, traditionally applied PE hinge mechanism articulation (HMA) components/bushings may fail, mainly as a consequence of insufficient creep and wear resistance [11–13]. For this reason, different alternatives to PE have been evaluated by Grupp et al [14, 15]. In this sense, carbon fiber reinforced poly-ether-ether-ketone (CFR-PEEK) represents an attractive alternative bearing material as it offers high creep and wear resistance and outstanding chemical resistance [16] and has already shown acceptable wear properties in hip and knee articulations [17–19].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Carbon Fiber Reinforced PEEK Hinge Mechanism Articulation Components in a Rotating Hinge Knee Design: A Comparison of In Vitro and Retrieval Findings

Schierjott

Giurea

Neuhaus

et al. 2016

BioMed Research International

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Carbon fiber reinforced poly-ether-ether-ketone (CFR-PEEK) represents a promising alternative material for bushings in total knee replacements, after early clinical failures of polyethylene in this application. The objective of the present study was to evaluate the damage modes and the extent of damage observed on CFR-PEEK hinge mechanism articulation components after in vivo service in a rotating hinge knee (RHK) system and to compare the results with corresponding components subjected to in vitro wear tests. Key question was if there were any similarities or differences between in vivo and in vitro damage characteristics. Twelve retrieved RHK systems after an average of 34.9 months in vivo underwent wear damage analysis with focus on the four integrated CFR-PEEK components and distinction between different damage modes and classification with a scoring system. The analysis included visual examination, scanning electron microscopy, and energy dispersive X-ray spectroscopy, as well as surface roughness and profile measurements. The main wear damage modes were comparable between retrieved and in vitro specimens (n = 3), whereby the size of affected area on the retrieved components showed a higher variation. Overall, the retrieved specimens seemed to be slightly heavier damaged which was probably attributable to the more complex loading and kinematic conditions in vivo.

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Biomechanical and bioactivity concepts of polyetheretherketone composites for use in orthopedic implants—a review

Abdullah

Goharian

Kadir

et al. 2015

J Biomedical Materials Res

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The use of polyetheretherketone (PEEK) composites in the trauma plating system, total replacement implants, and tissue scaffolds has found great interest among researchers. In recent years (2008 afterward), this type of composites has been examined for suitability as substitute material over stainless steel, titanium alloys, ultra high molecular weight polyethylene, or even biodegradable materials in orthopedic implant applications. Biomechanical and bioactivity concepts were contemplated for the development of PEEK orthopedic implants and a few primary clinical studies reported the clinical outcomes of PEEK-based orthopedic implants. This study aims to review and discuss the recent concepts and contribute further concepts in terms of biomechanical and bioactivity challenges for the development of PEEK and PEEK composites in orthopedic implants.

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Biotribology of a new bearing material combination in a rotating hinge knee articulation

Cited by 44 publications

References 53 publications

Early Results of a New Rotating Hinge Knee Implant

Early Results of a New Rotating Hinge Knee Implant

Analysis of Carbon Fiber Reinforced PEEK Hinge Mechanism Articulation Components in a Rotating Hinge Knee Design: A Comparison of In Vitro and Retrieval Findings

Biomechanical and bioactivity concepts of polyetheretherketone composites for use in orthopedic implants—a review

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