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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2008

Open Access 01-12-2008 | Research article

Damages of the tibial post in constrained total knee prostheses in the early postoperative course – a scanning electron microscopic study of polyethylene inlays

Authors: Adrian Skwara, Carsten O Tibesku, Rudolf Reichelt, Susanne Fuchs-Winkelmann

Published in: BMC Musculoskeletal Disorders | Issue 1/2008

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Abstract

Background

Investigation of the risk of fracture of the polyethylene (PE) inlay in constrained total knee prostheses.

Methods

Three unused and seven polyethylene inlays that had been implanted in a patient's knee for an average of 25.4 months (min 1.1 months, max 50.2 months) were investigated using scanning electron microscopy (SEM). All inlays were of the same type and size (Genesis II constrained, Smith & Nephew). The PE surface at the transition from the plateau to the post was analyzed.

Results

The unused inlays had fissure-free surfaces. All inlays that had been implanted in a patient's knee already had distinct fissures at the front and backside of the post.

Conclusion

The fissures of the transition from the plateau to the post indicated a loading-induced irreversible mechanical deformation and possibly cause the fracture of the inlay.
Appendix
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Literature
1.
Peters CL, Hennessey R, Barden RM, Galante JO, Rosenberg AG: Revision total knee arthroplasty with a cemented posterior-stabilized or constrained condylar prosthesis: a minimum 3-year and average 5-year follow-up study. J Arthroplasty. 1997, 12 (8): 896-903. 10.1016/S0883-5403(97)90159-5.CrossRefPubMed
2.
Barrack RL, Lyons TR, Ingraham RQ, Johnson JC: The use of a modular rotating hinge component in salvage revision total knee arthroplasty. J Arthroplasty. 2000, 15 (7): 858-866. 10.1054/arth.2000.9056.CrossRefPubMed
3.
Callaghan JJ, O'Rourke MR, Liu SS: The role of implant constraint in revision total knee arthroplasty: not too little, not too much. J Arthroplasty. 2005, 20 (4 Suppl 2): 41-43. 10.1016/j.arth.2005.03.008.CrossRefPubMed
4.
Mestha P, Shenava Y, D'Arcy JC: Fracture of the polyethylene tibial post in posterior stabilized (Insall Burstein II) total knee arthroplasty. J Arthroplasty. 2000, 15 (6): 814-815. 10.1054/arth.2000.6615.CrossRefPubMed
5.
Bal BS, Greenberg D: Failure of a metal-reinforced tibial post in total knee arthroplasty. J Arthroplasty. 2007, 22 (3): 464-467. 10.1016/j.arth.2006.04.011.CrossRefPubMed
6.
Mariconda M, Lotti G, Milano C: Fracture of posterior-stablized tibial insert in a Genesis knee prosthesis. J Arthroplasty. 2000, 15 (4): 529-530. 10.1054/arth.2000.4810.CrossRefPubMed
7.
Lombardi AV, Mallory TH, Fada RA, Adams JB, Kefauver CA: Fracture of the tibial spine of a Total Condylar III knee prosthesis secondary to malrotation of the femoral component. Am J Knee Surg. 2001, 14 (1): 55-59.PubMed
8.
Puloski SK, McCalden RW, MacDonald SJ, Rorabeck CH, Bourne RB: Tibial post wear in posterior stabilized total knee arthroplasty. An unrecognized source of polyethylene debris. J Bone Joint Surg Am. 2001, 83-A (3): 390-397.PubMed
9.
Li G, Papannagari R, Most E, Park SE, Johnson T, Tanamal L, Rubash HE: Anterior tibial post impingement in a posterior stabilized total knee arthroplasty. J Orthop Res. 2005, 23 (3): 536-541. 10.1016/j.orthres.2004.09.005.CrossRefPubMed
10.
Lavernia CJ, Sierra RJ, Hungerford DS, Krackow K: Activity level and wear in total knee arthroplasty: a study of autopsy retrieved specimens. J Arthroplasty. 2001, 16 (4): 446-453. 10.1054/arth.2001.23509.CrossRefPubMed
11.
Sawyer L.C. GDT: Polymer microscopy (2nd ed.). 1996, London , Chapman & HallCrossRef
12.
Goldstein J.J. NDE: Scanning electron microscopy and X-ray microanalysis. A text for biologists material scientists and geologists. 1981, New York: Plenum PressCrossRef
13.
Lafortune MA, Cavanagh PR, Sommer HJ, Kalenak A: Three-dimensional kinematics of the human knee during walking. J Biomech. 1992, 25 (4): 347-357. 10.1016/0021-9290(92)90254-X.CrossRefPubMed
14.
McPherson EJ, Vince KG: Breakage of a Total Condylar III knee prosthesis. A case report. J Arthroplasty. 1993, 8 (5): 561-563. 10.1016/S0883-5403(06)80029-X.CrossRefPubMed
15.
Kapandji I.: The physiology of the joints. The Knee. 1968, New York , Churchill Livingstone, 2:
16.
Andriacchi TP, Stanwyck TS, Galante JO: Knee biomechanics and total knee replacement. J Arthroplasty. 1986, 1 (3): 211-219. 10.1016/S0883-5403(86)80033-X.CrossRefPubMed
17.
Nisell R: Mechanics of the knee. A study of joint and muscle load with clinical applications. Acta Orthop Scand Suppl. 1985, 216: 1-42.CrossRefPubMed
18.
Blunn GW, Walker PS, Joshi A, Hardinge K: The dominance of cyclic sliding in producing wear in total knee replacements. Clin Orthop. 1991, 253-260.
19.
Banks SA, Harman MK, Hodge WA: Mechanism of anterior impingement damage in total knee arthroplasty. J Bone Joint Surg Am. 2002, 84-A Suppl 2: 37-42.PubMed
20.
Silva M, Kabbash CA, Tiberi JV, Park SH, Reilly DT, Mahoney OM, Schmalzried TP: Surface damage on open box posterior-stabilized polyethylene tibial inserts. Clin Orthop Relat Res. 2003, 135-144. 10.1097/01.blo.0000092998.90435.98.
21.
Callaghan JJ, O'Rourke MR, Goetz DD, Schmalzried TP, Campbell PA, Johnston RC: Tibial post impingement in posterior-stabilized total knee arthroplasty. Clin Orthop Relat Res. 2002, 83-88. 10.1097/00003086-200211000-00014.
22.
Muratoglu OK, Rubash HE, Bragdon CR, Burroughs BR, Huang A, Harris WH: Simulated normal gait wear testing of a highly cross-linked polyethylene tibial insert. J Arthroplasty. 2007, 22 (3): 435-444. 10.1016/j.arth.2006.07.014.CrossRefPubMed
23.
Buchanan FJ, Shipway PH: Microabrasion--a simple method to assess surface degradation of UHMWPE following sterilisation and ageing. Biomaterials. 2002, 23 (1): 93-100. 10.1016/S0142-9612(01)00083-7.CrossRefPubMed
Metadata
Title
Damages of the tibial post in constrained total knee prostheses in the early postoperative course – a scanning electron microscopic study of polyethylene inlays
Authors
Adrian Skwara
Carsten O Tibesku
Rudolf Reichelt
Susanne Fuchs-Winkelmann
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2008
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-9-83

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