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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Vydáno v:The Journal of arthroplasty Ročník 31; číslo 6; s. 1340 - 1345
Hlavní autoři: Pang, Hee-Nee, Bin Abd Razak, Hamid Rahmatullah, Jamieson, Paul, Teeter, Matthew G., Naudie, Douglas D.R., MacDonald, Steven J.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Inc 01.06.2016
Témata:
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
VVC
PE
Level II
wear
constrained
Prognostic
polyethylene
revision
ISSN:0883-5403, 1532-8406, 1532-8406
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Shrnutí: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.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0883-5403
1532-8406
1532-8406
DOI:10.1016/j.arth.2015.12.011