Failure of total knee arthroplasty due to loosening and deformation of the tibial component.

Ducheyne, Paul; Kagan, Abbott; Lacey, J A

doi:10.2106/00004623-197860030-00021

Cited by 162 publications

(49 citation statements)

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“…For the kneejoint, loosening incidences have been reported of 4% to 30%, the higher numbers being representative of the hinged prostheses (Peterson, 1977;Freeman et al, 1978;Ducheyne et al, 1978;Lacey, 1978). Loosening incidences of 3% to 30% were reported for e lbow prostheses, the high percentages certainly caused by the high torsional toading of the humeral component (Schlein, 1976;Nederpelt, 1978 and we re preceded by plastic deformation .…”

Section: Aseptie Looseningmentioning

confidence: 91%

Some Fundamental Aspects of Human Joint Replacement: Analyses of Stresses and Heat Conduction in Bone-Prosthesis Structures

Huiskes

1980

Acta Orthopaedica Scandinavica

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Section: Aseptie Looseningmentioning

confidence: 91%

Some Fundamental Aspects of Human Joint Replacement: Analyses of Stresses and Heat Conduction in Bone-Prosthesis Structures

Huiskes

1980

Acta Orthopaedica Scandinavica

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“…Early TKA designs used cemented all-polyethylene tibial (APT) components [6,7,9,12,18,21,28,33,38,39]. Both posterior-cruciate-preserving and posterior-cruciatesubstituting designs utilizing polymethylmethacrylate bone cement for fixation showed greater than 90% survivorship at followup of 10 or more years [11,31,32,36,37].…”

Section: Introductionmentioning

confidence: 99%

“…Both posterior-cruciate-preserving and posterior-cruciatesubstituting designs utilizing polymethylmethacrylate bone cement for fixation showed greater than 90% survivorship at followup of 10 or more years [11,31,32,36,37]. APT utilization decreased markedly in the late 1980s and 1990s due to several concerning reports about APT components [6,7,9,10,12]. Metal-backed tibial (MBT) components with modularity were introduced to improve intraoperative flexibility [11,21,36], provide options for revision surgery, and improve the survivorship of the tibial implant [2,37,38] by improving load transfer to the tibial plateau and improving fixation [33,38,39].…”

Section: Introductionmentioning

confidence: 99%

“…Although some early cemented APT components provided survivorship ranging from 96% to 98%, with revision as an end point at 5 to 14 years of followup [18,28], survivorship rates of 72% to 90% at 5 to 10 years' followup were reported in some TKA designs when indications were expanded to a higher-demand patient population [7,10,11,31,32,37]. Consequently, APT components became less frequently utilized, most often being implanted in older or lower-demand patients [1,22,26].…”

Section: Introductionmentioning

confidence: 99%

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All-polyethylene and Metal-backed Tibial Components Are Equivalent With BMI of Less Than 37.5

Toman¹,

Iorio²,

Healy³

2012

Clinical Orthopaedics &Amp; Related Research

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Background Modular, metal-backed tibial (MBT) components are associated with locking mechanism dysfunction, breakage, backside wear, and osteolysis, which compromise survivorship. All-polyethylene tibial (APT) components eliminate problems associated with MBTs, but, historically, APT utilization has generally been limited to older, less active patients. However, it is unclear whether APT utilization can be expanded to a nonselected patient population. Questions/purposes We therefore determined the survivorship of APT components compared with MBT components in a non-age-or activity-selected population who underwent TKA. Methods Using a longitudinal database, we identified 775 patients with primary TKAs utilizing a single implant design between 1999 and 2007. Of these, 558 (72%) patients had APT components (APT2), while 217 (28%) patients with tibial bone loss or defects, contralateral MBT components, or a BMI of greater than 37.5 received MBT components. We determined the survivorship in the two groups. The minimum followup was 2 years for both groups (mean ± SD: MBT, 80 ± 29 months; APT, 63 ± 27 months). The APT group was older (average age: APT2, 70 years; MBT, 64.7 years) and had a lower BMI than the MBT group (APT2, 30.8; MBT, 33.8).Results Survivorship, as defined by revision for any reason, was 99% for the APT group and 97% for the MBT group. There were four (2%) tibial failures in the MBT group in patients with a BMI of greater than 40. There were no revisions for loosening or osteolysis in the APT group. Conclusion APT implants perform as well as MBT implants in a non-age-or activity-selected TKA population with a BMI of less than 37.5. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…Marmor (1976Marmor ( , 1979 and Ducheyne et al (1978) warn against the use of thin, 5-6 mm polyethylene tibial components because of the high risk of deformation and loosening. However, not only are thin components still available but also new endoprosthesis designs with thin components have been introduced.…”

mentioning

confidence: 99%

Deformation and Loosening of the Tibial Component in Knee Arthroplasty with Unicompartmental Endoprostheses

Knutson

JóSnsson

Andersen

et al. 1981

Acta Orthopaedica Scandinavica

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Failure of total knee arthroplasty due to loosening and deformation of the tibial component.

Cited by 162 publications

References 0 publications

Some Fundamental Aspects of Human Joint Replacement: Analyses of Stresses and Heat Conduction in Bone-Prosthesis Structures

Some Fundamental Aspects of Human Joint Replacement: Analyses of Stresses and Heat Conduction in Bone-Prosthesis Structures

All-polyethylene and Metal-backed Tibial Components Are Equivalent With BMI of Less Than 37.5

Deformation and Loosening of the Tibial Component in Knee Arthroplasty with Unicompartmental Endoprostheses

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