Dissociation of the Tibial Component in Total Knee Replacements

Davis, Pamela F.; Bocell, James R.; Tullós, Hugh S.

doi:10.1097/00003086-199111000-00029

Cited by 25 publications

(21 citation statements)

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“…Our patient had an extreme flexion capacity which may lift the anterior rim, by producing stress on the posterior part of the polyethylene insert and promoting a sliding force forwards of the tibia (Shimagaki et al 1990, Davis et al 1991. This interpretation of the mechanism is supported by the wear pattern on the tibial components, presented in Figure 2.…”

Section: Discussionsupporting

confidence: 54%

“…Although dissociation of the polyethylene tray from the metal tibial plateau is a known complication after TKA (Davis et al 1991), it can easily be overlooked at an early stage. Our patient had an extreme flexion capacity which may lift the anterior rim, by producing stress on the posterior part of the polyethylene insert and promoting a sliding force forwards of the tibia (Shimagaki et al 1990, Davis et al 1991.…”

Section: Discussionmentioning

confidence: 99%

“…Certain locking mechanisms may also be more vulnerable to dissociation. The 2 cases reported by Davis et al (1991) had been performed with PCA ã tricompartmental knees (Howmedica, Rutherford, NJ, USA), uses a mechanism similar to the Kinemax knee. Both TKAs are very common in Sweden (The Swedish Knee Arthroplasty Register 1999).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Traumatic late dissociation of the polyethylene articulating surface in a total knee arthroplasty--a case report

Hedlundh¹,

Andersson²,

Enskog³

et al. 2000

Acta Orthopaedica Scandinavica

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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Traumatic late dissociation of the polyethylene articulating surface in a total knee arthroplasty--a case report

Hedlundh¹,

Andersson²,

Enskog³

et al. 2000

Acta Orthopaedica Scandinavica

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“…Furthermore, these mechanical properties should be important for maintaining the integrity of the locking mechanism. Lift‐off moment and micromotion between PE tibial insert and tibial tray may cause backside wear of PE and failure of locking mechanism 29, 30. Therefore, excessive cross‐linking could be detrimental.…”

Section: Introductionmentioning

confidence: 99%

Dose effects of cross‐linking polyethylene for total knee arthroplasty on wear performance and mechanical properties

et al. 2007

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Wear performance and mechanical properties of cross-linking polyethylene (XLPE) tibial inserts were investigated using a knee simulator, scanning electron microscopy (SEM), and a small punch test (SPT). Ultrahigh molecular weight PE made from GUR1050 resin was irradiated at doses ranging from 0 to 200 kGy and then machined into tibial inserts followed by annealing. The knee simulator was run for up to four million cycles. As the radiation dose increased from 0 to 100 kGy, the wear rate decreased dramatically, yielding 95% wear reduction at 100 kGy. The microwear features observed by SEM supported the dose-dependent wear reduction. The SPT for XLPE after the simulation test showed that, as the radiation dose increased from 0 to 200 kGy, the ultimate displacement decreased dose-dependently, while the ultimate load increased from 0 to 75 kGy and decreased from 75 to 200 kGy. The resulting toughness of the PE increased to its maximum at a dose of 50 kGy and then decreased with higher doses up to 200 kGy. PE cross-linked with radiation doses from 25 to 75 kGy had greater toughness than virgin, nonirradiated PE. However, PE irradiated with 100 kGy or more had lower toughness than virgin PE. These data suggest that a certain amount of irradiation enhances both wear performance and toughness of PE tibial inserts. Although a certain amount of cross-linking would be effective for clinical application of PE tibial inserts, an optimal radiation dose should be much smaller than that used in current XLPE in total hip arthroplasty.

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“…The purpose ofthe present report was threefold: (1) to present the assessment and management of a patient who had a dislodged poiyethyiene insert following total knee replacement, (2) to review the literature on this rare complication, and (3) to discuss possible mechanisms of failure. The patient was informed that data concerning the case would be submitted for publication.…”

mentioning

confidence: 99%

Spontaneous, Recurrent Dislodgment of the Polyethylene Tibial Insert After Total Knee Arthroplasty

Anderson¹,

MacDessi²,

Valle³

2007

The Journal of Bone & Joint Surgery

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Dissociation of the Tibial Component in Total Knee Replacements

Cited by 25 publications

References 0 publications

Traumatic late dissociation of the polyethylene articulating surface in a total knee arthroplasty--a case report

Traumatic late dissociation of the polyethylene articulating surface in a total knee arthroplasty--a case report

Dose effects of cross‐linking polyethylene for total knee arthroplasty on wear performance and mechanical properties

Spontaneous, Recurrent Dislodgment of the Polyethylene Tibial Insert After Total Knee Arthroplasty

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