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International Orthopaedics
Published in: International Orthopaedics 6/2012

Open Access 01-06-2012 | Original Paper

Polyethylene thickness is a risk factor for wear necessitating insert exchange

Authors: Bart G. Pijls, Henrica M. J. Van der Linden-Van der Zwaag, Rob G. H. H. Nelissen

Published in: International Orthopaedics | Issue 6/2012

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Abstract

Purpose

The aim of this observational study was to investigate the optimal minimal polyethylene (PE) thickness in total knee arthroplasty (TKA) and identify other risk factors associated with revision of the insert due to wear.

Methods

A total of 84 TKA were followed for 11–16 years. All patients received the same prosthesis design (Interax; Howmedica/ Stryker) with halfbearings: separate PE-inserts medially and laterally. Statistical analysis comprised Cox-regression to correct for confounding.

Results

Eight knees (9.5%) had been revised due to thinning inserts and an additional patient is scheduled for revision. PE thickness, diagnosis, BMI and weight are risk factors for insert exchange. For each millimetre decrease in PE thickness, the risk of insert exchange increases 3.0 times, which remains after correction for age, gender, weight, diagnosis and femoral-tibial angle. Insert exchange was 4.73 times more likely in OA-patients compared to RA-patients. For every unit increase in BMI and weight the risk for insert exchange increases 1.40 times and 1.14 times, respectively.

Conclusions

In conclusion we therefore advise against the use of thin PE inserts in modular TKA and recommend PE inserts with a minimal 8-mm thickness.
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Metadata
Title
Polyethylene thickness is a risk factor for wear necessitating insert exchange
Authors
Bart G. Pijls
Henrica M. J. Van der Linden-Van der Zwaag
Rob G. H. H. Nelissen
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 6/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1412-6

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