Polyethylene in total knee arthroplasty: Where are we now?

Wilhelm, Spencer K.; Henrichsen, Jacob L.; Siljander, Matthew P.; Moore, Drew D.; Karadsheh, Mark S.

doi:10.1177/2309499018808356

Cited by 29 publications

(17 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Existing short and midterm studies demonstrate no differences in revision rates between XLPE and CPE in TKA [ 32 , 34 ]. However, one long-term study (Australian joint registry) showed significantly lower revision rates at a 10-year follow-up with XLPE than CPE (3.5% versus 5.8%) [ 35 ].…”

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

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%

“…Notably, the wear particles from irradiated HXLPE are smaller and biologically more active than from non-irradiated ones. However, periprosthetic osteolysis is not commonly observed because of an overall reduction in the quantity of wear production in HXPLE compared to CPE [ 34 , 39 ].…”

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

“…The biomechanical rationale for using large-diameter femoral heads is that they allow for a greater range of motion and limit the risk of dislocation by increasing jump distance-distance the head has to "jump" before leaving the acetabular cup [27]. For total knee arthroplasty, however, clinical evidence has been inconclusive, and no distinctive improvement was observed when highly cross-linked polyethylene (HXLPE) was used compared to conventional UHMWPE [28][29][30]. This could be attributed to distinct biomechanical environments and different relative contributions of polyethylene wear mechanisms in the two types of joints: adhesive and abrasive wear in the hip versus fatigue wear and delamination in the knee.…”

Section: Cross-linked Polyethylenementioning

confidence: 99%

Biomechanical and Tribological Aspects of Orthopaedic Implants

Готман

2020

Springer Tracts in Mechanical Engineering

View full text Add to dashboard Cite

Orthopaedic and dental implant treatments have allowed to enhance the quality of life of millions of patients. Total hip/knee arthroplasty is a surgical replacement of the hip/knee joint with an artificial prosthesis. The aim of joint replacement surgery is to relieve pain improve function, often for sufferers of osteoarthritis, which affects around a third of people aged over fifty. Nowadays, total hip and knee replacement (THR) surgeries are considered routine procedures with generally excellent outcomes. Given the increasing life expectancy of the world population, however, many patients will require revision or removal of the artificial joint during their lifetime. The most common cause of failure of hip and knee replacements is mechanical instability secondary to wear of the articulating components. Thus, tribological and biomechanical aspects of joint arthroplasty are of specific interest in addressing the needs of younger, more active patients. The most significant improvements in the longevity of artificial joints have been achieved through the introduction of more wear resistant bearing surfaces. These innovations, however, brought about new tribocorrosion phenomena, such as fretting corrosion at the modular junctions of hip implants. Stiffness mismatch between the prosthesis components, non-physiological stress transfer and uneven implant-bone stress distribution are all involved in premature failure of hip arthroplasty. The development of more durable hip and knee prostheses requires a comprehensive understanding of biomechanics and tribocorrosion of implant materials. Some of these insights can also be applied to the design and development of dental implants.

show abstract

“…Several studies have analyzed the clinical differences between MB and fixed bearing inserts, mostly without any significant results in favor or against one treatment option for cemented Total Knee Arthroplasty (TKA) [ 17 – 20 ]. Simultaneously, total knee prostheses have substantially improved, especially in terms of the quality of polyethylene and fixation methods [ 21 ]. Recent long term randomized controlled trials with large cohorts and literature reviews reported of no differences in durability, function, range of movement and migration [ 5 , 8 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

No difference in clinical outcome, pain, and range of motion between fixed and mobile bearing Attune total knee arthroplasty: a prospective single-center trial

Ruckenstuhl

Revelant

Hauer

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Despite numerous scientific investigations, the tribological advantages of mobile bearing inserts have not been sustainably confirmed or refuted for modern knee prostheses in clinical studies. The purpose of this study was to compare fixed and mobile bearing inserts in order to draw conclusions regarding clinical benefits. Methods The present prospective single center cohort study of 2 non-randomized stratified groups consisted of 67 patients. All included patients received cemented total knee arthroplasty (Attune®) due to osteoarthritis. 34 patients were treated with a mobile and 33 patients with a fixed insert. The WOMAC score and the Visual Analogue Scale was used for the subjective assessment of success, while the Knee-Society-Score was used considering the Range of Motion for the objective assessment. The subjective and the clinical scores showed improvements for both compared groups postoperatively at 2 years of minimum follow-up. Results The overall postoperative results of the WOMAC score, the Knee-Society-Score and the Visual Analogue Scale presented no statistically difference between the compared groups (p > 0,05). The postoperative ROM showed a superior improvement of 13.2° ± 18.4° in the mobile-bearing group versus 4.9° ± 18.4° (p = 0.017) in the fixed-bearing group. The flexion of the knee joint was 114° ± 10.1° for the mobile-bearings and 109.2° ± 7.2° for fixed bearings (p = 0.012). Conclusion According to the findings, both inserts showed overall promising postoperative results, in terms of objective as well as subjective parameters, without clinically relevant significant differences, except for ROM, which was superior in the mobile bearing group. The present clinical trial has been registered at the ISRCTN registry with the reverence number ISRCTN15117998 on 04/04/2022.

show abstract

Polyethylene in total knee arthroplasty: Where are we now?

Cited by 29 publications

References 81 publications

Plastics in Total Knee Replacement: Processing to Performance

Plastics in Total Knee Replacement: Processing to Performance

Biomechanical and Tribological Aspects of Orthopaedic Implants

No difference in clinical outcome, pain, and range of motion between fixed and mobile bearing Attune total knee arthroplasty: a prospective single-center trial

Contact Info

Product

Resources

About