Backside wear in total knee replacement

• Verfasst von: Braun, Steffen [VerfasserIn]
• Verfasst von: Uhler, Maximilian [VerfasserIn]
• Verfasst von: Bormann, Therese [VerfasserIn]
• Verfasst von: Schröder, Stefan [VerfasserIn]
• Verfasst von: Jäger, Sebastian [VerfasserIn]
• Verfasst von: Sonntag, Robert [VerfasserIn]
• Verfasst von: Kretzer, Jan Philippe [VerfasserIn]
• Titel: Backside wear in total knee replacement
• Titelzusatz: a new quantitative measurement method and a comparison of polished cobalt-chromium tibial trays with titanium tibial trays
• Verf.angabe: Steffen Braun, Maximilian Uhler, Therese Bormann, Stefan Schroeder, Sebastian Jaeger, Robert Sonntag, Jan Philippe Kretzer
• Jahr: 2021
• Jahr des Originals: 2020
• Umfang: 11 S.
• Fussnoten: Available online 1 December 2020 ; Gesehen am 03.03.2021
• Titel Quelle: Enthalten in: Wear
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1957
• Jahr Quelle: 2021
• Band/Heft Quelle: 466/467(2021), Artikel-ID 203552
• ISSN Quelle: 0043-1648
• DOI: doi:10.1016/j.wear.2020.203552
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Backside wear
• Sach-SW: Cobalt-chromium-alloy
• Sach-SW: Particle analysis
• Sach-SW: Polished tibial tray
• Sach-SW: Total knee replacement
• K10plus-PPN: 1750138972

Abstract

Introduction - In modular total knee replacements, polyethylene backside wear can occur due to micro-motion between the tibial tray and polyethylene insert. Tibial trays manufactured from a cobalt-chromium alloy with highly polished surfaces are increasingly used to prevent backside wear. However, there is no quantitative evidence for this supposed wear advantage because previous evaluations only considered the subjective assessment of surface damage and changes without any information about the characteristics of the generated wear products. The validity about a true wear in the form of material removal is often missing. Therefore, this study used a new method to quantitatively investigate the possible wear advantage of polished cobalt-chromium tibial trays. - Materials and methods - Total knee replacements with titanium and polished cobalt-chromium tibial trays (SIGMA® DePuy Synthes & Johnson&Johnson, USA) were tested in a physiological knee wear simulator according to ISO-14243-1 for 3 x 106 cycles. The articulation side was hermetically separated from the backside of the insert. The serum was analyzed separately by particle analysis according to ASTM-F1877. - Results - With polished cobalt-chromium tibial trays, significantly (p = 0.003) less backside wear particles was generated. The backside wear particles differ significantly in size and morphology from the articulating particles. - Conclusion - In this study, backside wear was measured quantitatively and its wear particles were characterized for the first time. We demonstrated that even with modern inlay locking mechanisms and polished surfaces, wear particles on the backside can account for 15-33% of total wear. With polished cobalt-chromium trays, significantly less backside wear particles was generated.