Factors Affecting Wear of Constrained Polyethylene Tibial Inserts in Total Knee Arthroplasty
Wear in posterior-stabilized (PS) polyethylene tibial inserts depends on component position, limb alignment, and ligament balancing. Valgus-varus constrained (VVC) inserts are likely to be affected similarly. We aimed to compare wear characteristics of VVC and PS inserts and identify associated fact...
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| Published in: | The Journal of arthroplasty Vol. 31; no. 6; pp. 1340 - 1345 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
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Elsevier Inc
01.06.2016
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| ISSN: | 0883-5403, 1532-8406, 1532-8406 |
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| Abstract | Wear in posterior-stabilized (PS) polyethylene tibial inserts depends on component position, limb alignment, and ligament balancing. Valgus-varus constrained (VVC) inserts are likely to be affected similarly. We aimed to compare wear characteristics of VVC and PS inserts and identify associated factors.
This was a retrieval analysis (macroscopic and radiographic) of all 18 VVC liners collected from patients who underwent revision surgery from 1999 to 2011. These patients were matched to another group with PS inserts who underwent revision in the same time period.
There was significantly more damage in the posts of the VVC group (13.0 ± 5.0, compared to 4.7 ± 1.9 in the PS group; P < .001). Within the VVC group, the total damage score and cold flow damage were significantly higher with excessive joint line changes (≥5 mm; P = .01). The excessive joint line elevation was associated with rotational wear pattern of the post (P = .004). Damage scores were increased with femoral component malposition (P = .04), anterior tibial slope (P = .04), and tibial component malposition (P = .04).
Joint line elevation, femoral and tibial component malposition, and anterior tibial slope resulted in significantly more wear in the VVC inserts. Joint line elevation of >5 mm resulted in wear of the medial and lateral aspects of the post, femoral valgus resulted in cold flow wear of the anterior post, and tibial valgus and anterior slope resulted in wear of lateral aspect of the post. |
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| AbstractList | Wear in posterior-stabilized (PS) polyethylene tibial inserts depends on component position, limb alignment, and ligament balancing. Valgus-varus constrained (VVC) inserts are likely to be affected similarly. We aimed to compare wear characteristics of VVC and PS inserts and identify associated factors.BACKGROUNDWear in posterior-stabilized (PS) polyethylene tibial inserts depends on component position, limb alignment, and ligament balancing. Valgus-varus constrained (VVC) inserts are likely to be affected similarly. We aimed to compare wear characteristics of VVC and PS inserts and identify associated factors.This was a retrieval analysis (macroscopic and radiographic) of all 18 VVC liners collected from patients who underwent revision surgery from 1999 to 2011. These patients were matched to another group with PS inserts who underwent revision in the same time period.METHODSThis was a retrieval analysis (macroscopic and radiographic) of all 18 VVC liners collected from patients who underwent revision surgery from 1999 to 2011. These patients were matched to another group with PS inserts who underwent revision in the same time period.There was significantly more damage in the posts of the VVC group (13.0 ± 5.0, compared to 4.7 ± 1.9 in the PS group; P < .001). Within the VVC group, the total damage score and cold flow damage were significantly higher with excessive joint line changes (≥5 mm; P = .01). The excessive joint line elevation was associated with rotational wear pattern of the post (P = .004). Damage scores were increased with femoral component malposition (P = .04), anterior tibial slope (P = .04), and tibial component malposition (P = .04).RESULTSThere was significantly more damage in the posts of the VVC group (13.0 ± 5.0, compared to 4.7 ± 1.9 in the PS group; P < .001). Within the VVC group, the total damage score and cold flow damage were significantly higher with excessive joint line changes (≥5 mm; P = .01). The excessive joint line elevation was associated with rotational wear pattern of the post (P = .004). Damage scores were increased with femoral component malposition (P = .04), anterior tibial slope (P = .04), and tibial component malposition (P = .04).Joint line elevation, femoral and tibial component malposition, and anterior tibial slope resulted in significantly more wear in the VVC inserts. Joint line elevation of >5 mm resulted in wear of the medial and lateral aspects of the post, femoral valgus resulted in cold flow wear of the anterior post, and tibial valgus and anterior slope resulted in wear of lateral aspect of the post.CONCLUSIONJoint line elevation, femoral and tibial component malposition, and anterior tibial slope resulted in significantly more wear in the VVC inserts. Joint line elevation of >5 mm resulted in wear of the medial and lateral aspects of the post, femoral valgus resulted in cold flow wear of the anterior post, and tibial valgus and anterior slope resulted in wear of lateral aspect of the post. Wear in posterior-stabilized (PS) polyethylene tibial inserts depends on component position, limb alignment, and ligament balancing. Valgus-varus constrained (VVC) inserts are likely to be affected similarly. We aimed to compare wear characteristics of VVC and PS inserts and identify associated factors. This was a retrieval analysis (macroscopic and radiographic) of all 18 VVC liners collected from patients who underwent revision surgery from 1999 to 2011. These patients were matched to another group with PS inserts who underwent revision in the same time period. There was significantly more damage in the posts of the VVC group (13.0 ± 5.0, compared to 4.7 ± 1.9 in the PS group; P < .001). Within the VVC group, the total damage score and cold flow damage were significantly higher with excessive joint line changes (≥5 mm; P = .01). The excessive joint line elevation was associated with rotational wear pattern of the post (P = .004). Damage scores were increased with femoral component malposition (P = .04), anterior tibial slope (P = .04), and tibial component malposition (P = .04). Joint line elevation, femoral and tibial component malposition, and anterior tibial slope resulted in significantly more wear in the VVC inserts. Joint line elevation of >5 mm resulted in wear of the medial and lateral aspects of the post, femoral valgus resulted in cold flow wear of the anterior post, and tibial valgus and anterior slope resulted in wear of lateral aspect of the post. Abstract Background Wear in posterior-stabilized (PS) polyethylene tibial inserts depends on component position, limb alignment, and ligament balancing. Valgus-varus constrained (VVC) inserts are likely to be affected similarly. We aimed to compare wear characteristics of VVC and PS inserts and identify associated factors. Methods This was a retrieval analysis (macroscopic and radiographic) of all 18 VVC liners collected from patients who underwent revision surgery from 1999 to 2011. These patients were matched to another group with PS inserts who underwent revision in the same time period. Results There was significantly more damage in the posts of the VVC group (13.0 ± 5.0, compared to 4.7 ± 1.9 in the PS group; P < .001). Within the VVC group, the total damage score and cold flow damage were significantly higher with excessive joint line changes (≥5 mm; P = .01). The excessive joint line elevation was associated with rotational wear pattern of the post ( P = .004). Damage scores were increased with femoral component malposition ( P = .04), anterior tibial slope ( P = .04), and tibial component malposition ( P = .04). Conclusion Joint line elevation, femoral and tibial component malposition, and anterior tibial slope resulted in significantly more wear in the VVC inserts. Joint line elevation of >5 mm resulted in wear of the medial and lateral aspects of the post, femoral valgus resulted in cold flow wear of the anterior post, and tibial valgus and anterior slope resulted in wear of lateral aspect of the post. |
| Author | Naudie, Douglas D.R. Pang, Hee-Nee MacDonald, Steven J. Teeter, Matthew G. Jamieson, Paul Bin Abd Razak, Hamid Rahmatullah |
| Author_xml | – sequence: 1 givenname: Hee-Nee surname: Pang fullname: Pang, Hee-Nee organization: Department of Orthopaedic Surgery, Singapore General Hospital, Academia Level 4, Singapore – sequence: 2 givenname: Hamid Rahmatullah orcidid: 0000-0002-2701-9057 surname: Bin Abd Razak fullname: Bin Abd Razak, Hamid Rahmatullah organization: Department of Orthopaedic Surgery, Singapore General Hospital, Academia Level 4, Singapore – sequence: 3 givenname: Paul surname: Jamieson fullname: Jamieson, Paul organization: Division of Orthopaedic Surgery, Joint Replacement Institute, London Health Sciences Centre, London, Ontario, Canada – sequence: 4 givenname: Matthew G. surname: Teeter fullname: Teeter, Matthew G. organization: Division of Orthopaedic Surgery, Joint Replacement Institute, London Health Sciences Centre, London, Ontario, Canada – sequence: 5 givenname: Douglas D.R. surname: Naudie fullname: Naudie, Douglas D.R. organization: Division of Orthopaedic Surgery, Joint Replacement Institute, London Health Sciences Centre, London, Ontario, Canada – sequence: 6 givenname: Steven J. surname: MacDonald fullname: MacDonald, Steven J. organization: Division of Orthopaedic Surgery, Joint Replacement Institute, London Health Sciences Centre, London, Ontario, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26777549$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1055_s_0044_1789017 crossref_primary_10_1016_j_csm_2018_05_009 crossref_primary_10_7759_cureus_48950 crossref_primary_10_1142_S0219519425400561 crossref_primary_10_1007_s00264_018_4200_8 crossref_primary_10_1016_j_arth_2018_04_010 crossref_primary_10_1002_jor_24710 crossref_primary_10_1016_j_artd_2017_11_001 crossref_primary_10_1016_j_artd_2019_06_001 crossref_primary_10_1007_s00167_018_4891_9 |
| Cites_doi | 10.1016/j.arth.2008.06.030 10.1097/01.blo.0000148578.22729.0e 10.1007/s11999-012-2387-3 10.1097/00003086-200211000-00014 10.1016/j.arth.2005.09.008 10.2106/00004623-198668070-00009 10.1097/00003086-198801000-00009 10.1186/1471-2474-9-83 10.1007/s00167-011-1652-4 10.1016/j.arth.2010.07.013 10.1007/s11999-010-1515-1 10.1002/jbm.820170510 10.1097/00003086-199402000-00005 10.1007/s11999-008-0470-6 10.2106/00004623-200103000-00011 10.1016/0021-9290(91)90003-6 10.1016/S0883-5403(03)00192-X 10.1007/s11999-008-0422-1 10.2106/00004623-199702000-00015 10.1016/j.knee.2011.11.003 10.1097/00003086-199402000-00008 10.1016/0021-9290(92)90254-X 10.1097/00003086-199112000-00036 10.1016/j.arth.2007.08.002 10.1016/j.arth.2010.05.011 |
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| Keywords | VVC PE Level II wear constrained Prognostic polyethylene revision |
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| Snippet | Wear in posterior-stabilized (PS) polyethylene tibial inserts depends on component position, limb alignment, and ligament balancing. Valgus-varus constrained... Abstract Background Wear in posterior-stabilized (PS) polyethylene tibial inserts depends on component position, limb alignment, and ligament balancing.... |
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| SubjectTerms | Aged Aged, 80 and over Arthroplasty, Replacement, Knee - methods Biomechanical Phenomena constrained Female Femur - surgery Humans Joint Prosthesis Knee Joint - surgery Knee Prosthesis Male Middle Aged Orthopedics polyethylene Polyethylene - chemistry Prosthesis Failure Reoperation revision Tibia - surgery VVC wear |
| Title | Factors Affecting Wear of Constrained Polyethylene Tibial Inserts in Total Knee Arthroplasty |
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