Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage

Mathis, Dominic T.; Schmidli, Joshua; Hirschmann, Michael T.; Amsler, Felix; Henckel, Johann; Hothi, Harry; Hart, Alister

doi:10.1186/s12891-021-04898-y

Cited by 5 publications

(7 citation statements)

References 21 publications

(24 reference statements)

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“…Usually, the polyethylene insert deteriorates due to lower interactions between polymer chains by comparing it with those determined in the case of atoms’ interactions in metallic or ceramic materials [ 61 , 74 ]. We have found for our retrieved UHMWPE inserts that delamination (M5) is the most important deterioration mode that is in good agreement with the literature [ 78 , 79 ]. Delamination is found for three samples, being much more pronounced in the case of the IT4 sample.…”

Section: Resultssupporting

confidence: 91%

Failure Analysis of Ultra-High Molecular Weight Polyethylene Tibial Insert in Total Knee Arthroplasty

Paltanea

Antoniac

et al. 2022

Materials

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Knee osteoarthritis is treated based on total knee arthroplasty (TKA) interventions. The most frequent failure cause identified in surgical practice is due to wear and oxidation processes of the prothesis’ tibial insert. This component is usually manufactured from ultra-high molecular weight polyethylene (UHMWPE). To estimate the clinical complications related to a specific prosthesis design, we investigated four UHMWPE tibial inserts retrieved from patients from Clinical Hospital Colentina, Bucharest, Romania. For the initial analysis of the polyethylene degradation modes, macrophotography was chosen. A light stereomicroscope was used to estimate the structural performance and the implant surface degradation. Scanning electron microscopy confirmed the optical results and fulfilled the computation of the Hood index. The oxidation process in UHMWPE was analyzed based on Fourier-transform infrared spectroscopy (FTIR). The crystallinity degree and the oxidation index were computed in good agreement with the existing standards. Mechanical characterization was conducted based on the small punch test. The elastic modulus, initial peak load, ultimate load, and ultimate displacement were estimated. Based on the aforementioned experimental tests, a variation between 9 and 32 was found in the case of the Hood score. The oxidation index has a value of 1.33 for the reference sample and a maximum of 9.78 for a retrieved sample.

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Section: Resultssupporting

confidence: 91%

Failure Analysis of Ultra-High Molecular Weight Polyethylene Tibial Insert in Total Knee Arthroplasty

Paltanea

Antoniac

et al. 2022

Materials

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“…Similar to all retrieval studies, the present study has a considerable number of limitations [ 27 ]. First, it was a small sample size, however, this was the first study of its kind for the Persona® implant.…”

Section: Discussionmentioning

confidence: 99%

“…To measure the surface roughness on the backside of the tibial tray, a well-established method was applied by using a contact profilometer Talyrond 365 (Taylor Hobson, Leicester, UK) with a 5-μm probe [ 27 ]. Surface roughness is defined as the average of the absolute values of the surface height deviations measured from the mean plane.…”

Section: Methodsmentioning

confidence: 99%

“…More anatomical implant designs may optimize clinical outcome with an improved fit to patient anatomy [ 26 ]. In a recent study, Mathis et al have demonstrated that PE damages of the novel anatomic knee system are not significantly different from those of its predecessor knee system [ 27 ]. The only difference they were able to show was a significantly smoother surface of the articulating side of the tibial tray compared to the predecessor knee system [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…In a recent study, Mathis et al have demonstrated that PE damages of the novel anatomic knee system are not significantly different from those of its predecessor knee system [ 27 ]. The only difference they were able to show was a significantly smoother surface of the articulating side of the tibial tray compared to the predecessor knee system [ 27 ]. However, the study did not reveal retrieval results regarding the tibial tray backsides of the two implant designs.…”

Section: Introductionmentioning

confidence: 99%

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Comparative retrieval analysis of a novel anatomic tibial tray backside: alterations in tibial component design and surface coating can increase cement adhesions and surface roughness

Mathis

Schmidli

Amsler

et al. 2022

BMC Musculoskelet Disord

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Background With the Persona® knee system a novel anatomic total knee design was developed, which has no pre-coating, whereas the predecessor knee system is pre-coated with polymethylmethacrylate (PMMA). Joint registry data have shown no decrease in risk of aseptic revision of PMMA pre-coated tibial components compared with non-pre-coated implants. The aim of this retrieval study was to compare the amount of cement adhesions, geometry and surface features between the two knee designs and to correlate them with the underlying reason for revision surgery. Methods Retrieval analysis was performed of 15 NexGen® and 8 Persona® fixed-bearing knee implants from the same manufacturer retrieved from two knee revision centres. A photogrammetric method was used to grade the amount of cement attached to the tibial tray backside. The geometry and dimensions of the tibial trays, tray projections and peripheral lips were measured using digital callipers and compared between the two different designs. To measure the surface roughness on the backside of the tibial tray, a contact profilometer was used. To investigate differences between the two designs statistical analyses (t-test) were performed. Results All Persona® trays showed evidence of cement adhesion with a % area of 75.4%; half of the NexGen® trays had cement adhesions, with a mean value of 20%. There was a significant difference in the percentage of area covered by cement between the two designs (p < 0.001). Results from the contact profilometer revealed that Persona® and NexGen® tray backsides showed a similar lateral (1.36 μm and 1.10 μm) and medial (1.39 μm and 1.12 μm) mean surface roughness with significant differentiation (p < 0.05) of the lateral and medial roughness values between the two designs. Persona® stems showed a significantly higher mean surface roughness (1.26) compared to NexGen® stems (0.89; p < 0.05). Conclusion The novel anatomic knee system showed significantly more cements adhesions and a higher surface roughness which was most likely attributed to the most obvious design and coating alteration of the tibial tray. This study provides first retrieval findings of a novel TKA design recently introduced to the market.

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A Review of Early In Vivo Performance of Antioxidant Stabilized Polyethylene for Total Knee Arthroplasty

Spece¹,

Yarbrough²,

Kurtz³

2023

The Journal of Arthroplasty

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Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage

Cited by 5 publications

References 21 publications

Failure Analysis of Ultra-High Molecular Weight Polyethylene Tibial Insert in Total Knee Arthroplasty

Failure Analysis of Ultra-High Molecular Weight Polyethylene Tibial Insert in Total Knee Arthroplasty

Comparative retrieval analysis of a novel anatomic tibial tray backside: alterations in tibial component design and surface coating can increase cement adhesions and surface roughness

A Review of Early In Vivo Performance of Antioxidant Stabilized Polyethylene for Total Knee Arthroplasty

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