Comparison of long-term kinematics and wear of total knee arthroplasty implant designs
| Autor: | Brent A. Lanting, Jordan S. Broberg, Steven J. MacDonald, Matthew G. Teeter, Richard W. McCalden, Caleigh E. Bourdon, Douglas D.R. Naudie |
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| Rok vydání: | 2021 |
| Předmět: |
Orthodontics
Materials science Knee Joint Biomedical Engineering Total knee arthroplasty Kinematics Genesis ii Condyle Radiostereometric Analysis Biomechanical Phenomena Biomaterials Wear resistance Mechanics of Materials Humans In patient Implant Range of Motion Articular Arthroplasty Replacement Knee Knee Prosthesis |
| Zdroj: | Journal of the mechanical behavior of biomedical materials. 124 |
| ISSN: | 1878-0180 |
| Popis: | We sought to evaluate wear and kinematics in well-established implants of posterior stabilized (PS) and cruciate retaining (CR) designs. Ninety-one knees implanted for at least five years were examined. The implants were Genesis II PS (Smith & Nephew, Memphis, TN), Sigma PS (DePuy Synthes, Warsaw, IN), or Sigma CR. Radiostereometric analysis (RSA) images were acquired at multiple flexion angles and the 3D positions of the implant components were determined using model-based RSA software. The location of the center of the contact area between the femoral and polyethylene components was used to obtain contact kinematics, and the magnitude of the virtual intersection between the components indicated linear wear. All three groups had paradoxical anterior motion on both condyles, experienced similar net external rotation, and exhibited instances of internal rotation during flexion. The maximum observed wear rate was significantly greater for the Sigma PS than the Genesis II PS on the medial condyle (mean difference = 0.032 mm/year, p = 0.044), but not the lateral condyle, while there was no difference between the Sigma PS and Sigma CR for either condyle. Knees with lateral condylar separation had greater maximum wear rates on the medial condyle (mean difference = 0.033 mm/year, p = 0.001), while those with medial condylar separation had greater maximum wear rates on the lateral condyle (mean difference = 0.044 mm/year, p = 0.014). At long term follow-up in patients with well-functioning implants, there were differences in kinematics and wear resistance between implants. These results suggest that implant design affects long-term kinematics and wear in well-functioning implants and that condylar separation should be avoided to minimize wear. |
| Databáze: | OpenAIRE |
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