Fracture of the polyethylene tibial post in a NexGen posterior-stabilized knee prosthesis

Chiu, Yen-Shuo; Chen, Wei-Ming; Huang, Ching-Kuei; Chiang, Chao-Ching; Chen, Tain-Hsiung

doi:10.1016/j.arth.2004.04.013

Cited by 86 publications

(49 citation statements)

References 8 publications

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“…Although the orthopaedic literature is mixed regarding the wear-related effects of cruciate retention versus substitution [10,12,17,23,27,31,33,34,47,49], two studies identified osteolysis and wear problems associated with a posterior stabilized design [15,37]. In addition to shape, the properties of the polyethylene constitute one of the critical variables affecting wear of the tibial insert.…”

Section: Discussionmentioning

confidence: 97%

Cruciate-retaining TKA Using a Third-generation System with a Four-pegged Tibial Component: A Minimum 10-year Followup Note

Schwartz

Valle

Rosenberg

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 97%

Cruciate-retaining TKA Using a Third-generation System with a Four-pegged Tibial Component: A Minimum 10-year Followup Note

Schwartz

Valle

Rosenberg

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Post-irradiation melting leads to a decrease in the crystallinity of the polymer; further decreasing the fatigue strength of irradiated UHMWPE [6]. Fatigue failure of UHMWPE components has been a rare occurrence mostly due to severe oxidation [7,8]. Nevertheless, fatigue damage, especially in components under high cyclic stresses, is a major problem after wear, limiting the longevity of joint implants.…”

Section: Introductionmentioning

confidence: 99%

Characterization of irradiated blends of α-tocopherol and UHMWPE

et al. 2005

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Adhesive/abrasive wear in ultra-high molecular weight polyethylene (UHMWPE) has been minimized by radiation cross-linking. Irradiation is followed by melting to eliminate residual free radicals and avoid long-term oxidative embrittlement. However, post-irradiation melting reduces the crystallinity of the polymer and hence its strength and fatigue resistance. We proposed an alternative to post-irradiation melting to be the incorporation of the antioxidant α-tocopherol into UHMWPE prior to consolidation. α-Tocopherol is known to react with oxygen and oxidized lipids, stabilizing them against further oxidative degradation reactions. We blended GUR 1050 UHMWPE resin powder with α-tocopherol at 0.1 and 0.3 wt% and consolidated these blends. Then we gammairradiated these blends to 100-kGy. We characterized the effect of α-tocopherol on the cross-linking efficiency, oxidative stability, wear behavior and mechanical properties of the blends. (I) The crosslink density of virgin, 0.1 and 0.3 wt% α-tocopherol blended, 100-kGy irradiated UHMWPEs were 175±19, 146±4 and 93±4 mol/m 3 , respectively. (II) Maximum oxidation indices for 100-kGy irradiated UHMWPE previously blended with 0, 0.1 and 0.3 wt% α-tocopherol that were subjected to accelerated aging at 80 °C in air for 5 weeks were 3.32, 0.09, and 0.05, respectively. (III) The pinon-disc wear rates of 100-kGy irradiated UHMWPE previously blended with 0.1 and 0.3 wt% α-tocopherol that were subjected to accelerated aging at 80 °C in air for 5 weeks were 2.10±0.17 and 5.01±0.76 mg/million cycles, respectively. (IV) Both accelerated aged, α-tocopherol-blended 100-kGy irradiated UHMWPEs showed higher ultimate tensile strength, higher yield strength, and lower elastic modulus when compared to 100-kGy irradiated, virgin UHMWPE. These results showed that α-tocopherol-blended 100-kGy irradiated UHMWPEs were not cross-linked to the same extent as the 100-kGy irradiated, virgin UHMWPE.

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“…These patients were treated by revision using a deep-dish congruent tibial liner, with a mean followup of 28 months (range, 13-61 months). There were eight different posteriorstabilized prostheses in the 27 other cases of tibial post fractures: 11 Insall-Burstein II1 [9,14,15,20,28], one Insall-Burstein I1 [14], three NexGen1 (all Zimmer) [8,11,23], four Scorpio1 (Stryker, Mahwah NJ, USA) [17,18,25], four Genesis1 (Smith & Nephew, Memphis, TN, USA) [19,26,30], two PFC-Sigma1 [3,32], one AMK (both DePuy, Warsaw IN, USA) [29], and one DualArticular1 [5] …”

Section: Resultsmentioning

confidence: 99%