Factors affecting polyethylene wear in total knee arthroplasty
Markus Kuster & Gwidon W Stachowiak
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Kurzfassung
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A complication of total knee arthroplasty (TKA) is fatigue-type
wear, which can destroy a tibial inlay in <10 years. This
deleterious wear mechanism occurs during cyclic loading if the yield
stress of polyethylene is exceeded. Because increased stress on and
within the polyethylene inlay is associated with increased wear, it
is important to reduce the inlay stress by either activity
restrictions or conformity changes of design. All stress parameters
are more sensitive to conformity changes (eg, design changes) than
to load changes (eg, activity restrictions). However, the reduction
of stress on and within the polyethylene through increased
conformity will increase the stress at the tibial fixation
interfaces. An attempt was made to solve this problem with the
introduction of mobile-bearing designs. Many mobile-bearing designs
exist with good long-term results. One important difference among
the various designs is the amount of flexion range with full
conformity between the femoral component and the tibial inlay.
Although a single radius design reduces polyethylene stress
throughout the flexion range, it may be disadvantageous for a
revision design to intraoperatively adapt to different degrees of
constraint. Aseptic loosening and osteolysis due to small abrasive
and adhesive wear particles have also been reported as a cause of
failure. The design and material parameters affecting polyethylene
wear in TKAs, as well as the potential detrimental effects of wear
particle size, are the key issues in defining the life of a TKA.
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Zitation
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kuster m, Stachowiak G W. Factors affecting polyethylene wear in
total knee arthroplasty. Orthopedics 2002; 25:s235-42.
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Typ
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Wissenschaftlicher Artikel/Review (Englisch)
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Veröffentlichungsdatum
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2-2002
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Titel der Zeitschrift
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Orthopedics (25/2 Suppl)
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ISSN print
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0147-7447
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Seiten
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s235-42
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PubMed
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11866159
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