Early failure of sequentially annealed polyethylene in total knee arthroplasty

Sonn, Kevin A.; Meneghini, R. Michael

doi:10.1016/j.artd.2019.12.005

Cited by 8 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A knee simulator study comparing six poly designs demonstrated the lowest wear rates with X3 poly [ 16 ]. However, early failures with fractures and oxidation damage have been reported with this design affecting mainly the posteromedial and lateral borders [ 17 ]. Although there are no long term data using X3 in TKA, the short term studies have demonstrated superior wear characteristics [ 18 , 19 ].…”

Section: Reviewmentioning

confidence: 99%

Plastics in Total Knee Replacement: Processing to Performance

Cheppalli¹,

Metikala²,

Albertson³

et al. 2021

Cureus

View full text Add to dashboard Cite

Polyethylene (PE) is the key component of total knee replacement (TKR). The wear of polyethylene, a common cause of revision surgeries, depends on multiple factors. The mechanical properties, wear characteristics, and oxidative resistance of PE can be manipulated by the techniques of processing, sterilization, and packaging methods. This article describes the making of conventional and cross-linked poly, packaging, sterilization, processing techniques, and a summary of commercially available plastics and their rationale in TKR including the latest advances.

show abstract

Section: Reviewmentioning

confidence: 99%

Plastics in Total Knee Replacement: Processing to Performance

Cheppalli¹,

Metikala²,

Albertson³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…There are only a very limited number of case reports of previous failure of the X3® in TKA, and the failure modes were different than this report. Sonn and Meneghini [ 14 ] discussed an early failure of X3® at 5 years. The mechanism of failure was a completely worn through polyethylene.…”

Section: Discussionmentioning

confidence: 99%

Massive Osteolysis in a Modern Total Knee Prosthesis

Gibon

Knapik

Parvataneni

2021

Case Reports in Orthopedics

View full text Add to dashboard Cite

Case. An 82-year-old woman underwent right total knee replacement with a sequentially irradiated and annealed highly cross-linked polyethylene insert. At 9 years, she was found to have a massive femoral osteolysis with an impending fracture. Conclusion. This case demonstrates a rare occurrence of massive femoral osteolysis, requiring revision surgery, with a sequentially irradiated and annealed highly cross-linked polyethylene.

show abstract

“…At our retrieval centre, we receive explanted TKAs from hospitals as part of routine clinical practice. For the current study, we identified all explanted fixed-bearing TKAs of four widely used contemporary designs: Attune used with an AOX antioxidant PE insert (DePuy, USA); NexGen (Zimmer, USA); PFC (Press Fit Condylar) used with D∑GVF PE (DePuy); and Triathlon used with an X3 PE insert (Stryker Orthopaedics, USA 11 ), which were revised for any indication (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Tibial tray debonding from the cement mantle is associated with deformation of the backside of polyethylene tibial inserts

Bhalekar¹,

Nargol²,

Shyam³

et al. 2021

The Bone & Joint Journal

View full text Add to dashboard Cite

Aims The aim of this study was to investigate whether wear and backside deformation of polyethylene (PE) tibial inserts may influence the cement cover of tibial trays of explanted total knee arthroplasties (TKAs). Methods At our retrieval centre, we measured changes in the wear and deformation of PE inserts using coordinate measuring machines and light microscopy. The amount of cement cover on the backside of tibial trays was quantified as a percentage of the total surface. The study involved data from the explanted fixed-bearing components of four widely used contemporary designs of TKA (Attune, NexGen, Press Fit Condylar (PFC), and Triathlon), revised for any indication, and we compared them with components that used previous generations of PE. Regression modelling was used to identify variables related to the amount of cement cover on the retrieved trays. Results A total of 114 explanted fixed-bearing TKAs were examined. This included 76 used with contemporary PE inserts which were compared with 15 used with older generation PEs. The Attune and NexGen (central locking) trays were found to have significantly less cement cover than Triathlon and PFC trays (peripheral locking group) (p = 0.001). The median planicity values of the PE inserts used with central locking trays were significantly greater than of those with peripheral locking inserts (205 vs 85 microns; p < 0.001). Attune and NexGen inserts had a characteristic pattern of backside deformation, with the outer edges of the PE deviating inferiorly, leaving the PE margins as the primary areas of articulation. Conclusion Explanted TKAs with central locking mechanisms were significantly more likely to debond from the cement mantle. The PE inserts of these designs showed characteristic patterns of deformation, which appeared to relate to the manufacturing process and may be exacerbated in vivo. This pattern of deformation was associated with PE wear occurring at the outer edges of the articulation, potentially increasing the frictional torque generated at this interface.

show abstract

Early failure of sequentially annealed polyethylene in total knee arthroplasty

Cited by 8 publications

References 14 publications

Plastics in Total Knee Replacement: Processing to Performance

Plastics in Total Knee Replacement: Processing to Performance

Massive Osteolysis in a Modern Total Knee Prosthesis

Tibial tray debonding from the cement mantle is associated with deformation of the backside of polyethylene tibial inserts

Contact Info

Product

Resources

About