Oxidation, Damage Mechanisms, and Reasons for Revision of Sequentially Annealed Highly Crosslinked Polyethylene in Total Knee Arthroplasty
Daniel W. MacDonald,Genymphas B. Higgs,Antonia F. Chen,Arthur L. Malkani,Michael A. Mont,Steven M. Kurtz +5 more
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TLDR
The findings of this study document the revision reasons, surface damage modes, and oxidative behavior of sequentially annealed HXLPE for TKA and observed evidence of in vivo oxidation in both H XLPE and control tibial inserts.Abstract:
Background Sequentially annealed, highly crosslinked polyethylene (HXLPE) has been used clinically in total knee arthroplasty (TKA) for over a decade However, little is known about the revision reasons; its surface damage mechanisms; or its in vivo oxidative stability relative to conventional polyethylene We asked whether retrieved HLXPE tibial inserts exhibited: (1) similar revision reasons; (2) improved resistance to surface damage; and (3) improved oxidative stability, when compared with conventional gamma inert sterilized polyethylene inserts Methods A total of 456 revised tibial inserts were collected in a multicenter retrieval program between 2000 and 2016 The implantation time for the HXLPE components was 18 ± 18 years, and for the control inserts it was 34 ± 27 years Revision reasons were assessed based on medical records, radiographs, and examinations of the retrieved components Surface damage was assessed using a semi-quantitative scoring method Oxidation was measured using Fourier transform infrared spectroscopy Results The tibial inserts in both cohorts were revised most frequently for loosening, infection, and instability The most commonly observed surface damage modes were burnishing, pitting, and scratching Oxidation of the HXLPE inserts was, on average, low and similar to the control inserts at the bearing surface and the stabilizing post Conclusions We observed evidence of in vivo oxidation in both HXLPE and control tibial inserts We found no association between the levels of oxidation and the clinical performance of the HXLPE tibial components The findings of this study document the revision reasons, surface damage modes, and oxidative behavior of sequentially annealed HXLPE for TKAread more
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References
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Why are total knee arthroplasties failing today
TL;DR: Fifty percent of early revision total knee arthroplasties in this series were related to instability, malalignment or malposition, and failure of fixation, and half of the revisions in this group of patients were done less than 2 years after the index operation.
Journal ArticleDOI
The epidemiology of revision total knee arthroplasty in the United States.
Kevin J. Bozic,Steven M. Kurtz,Edmund Lau,Kevin L. Ong,Vanessa Chiu,Thomas P. Vail,Harry E. Rubash,Daniel J. Berry +7 more
TL;DR: Revision TKA procedures were most commonly performed in large, urban, nonteaching hospitals in Medicare patients ages 65 to 74, and the average length of hospital stay was 5.1 days, the average total charges were $49,360, however, average LOS, average charges, and procedure frequencies varied considerably by census region, hospital type, and Procedure performed.
Journal ArticleDOI
Retrieval analysis of total knee prostheses: A method and its application to 48 total condylar prostheses
TL;DR: For the 48 total condylar-type prostheses, significant positive correlations were found for the surface damage correlated with the patient's weight and the time the prosthesis was implanted.
Book
UHMWPE Biomaterials Handbook: Ultra High Molecular Weight Polyethylene in Total Joint Replacement and Medical Devices
TL;DR: The UHMWPE Handbook is the comprehensive reference for professionals, researchers, and clinicians working with biomaterials technologies for joint replacement, providing a more complete reference for industrial and academic materials specialists, and for surgeons and clinicians who require an understanding of the biomaterial's properties to work successfully on patient applications.
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The Chitranjan Ranawat Award: Long-term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties.
TL;DR: In this paper, the authors examined factors affecting survivorship, and reasons for reoperation and revision of a cemented modular condylar total knee arthroplasty (TKA).