Comparison of polyethylene tibial insert damage from in vivo function and in vitro wear simulation

Autor: Lisa Benson, W. Andrew Hodge, John D. DesJardins, Martine LaBerge, Melinda K. Harman, Scott A. Banks
Rok vydání: 2009
Předmět:
Zdroj: Journal of Orthopaedic Research. 27:540-548
ISSN: 1554-527X
0736-0266
DOI: 10.1002/jor.20743
Popis: Function and wear of total knee arthroplasties were compared by analysis of damage patterns on polyethylene tibial inserts retrieved from patients (Group R) with inserts obtained after in vitro force-controlled knee joint wear simulation. Two simulator input profiles were evaluated, including standard walking (Group W), and combined walking and stair descent (Group W + S), simulating varied activities and a more severe physiological environment. Damage regions on all inserts were quantitatively assessed. On average, inserts in all groups had internally rotated damage patterns and the greatest articular deformation in the lateral compartment. These patterns were more pronounced in Group W + S compared to Group W. Deformation rates of simulated inserts were analogous to about six years of physiologic function. However, both groups of simulated inserts generally underestimated the magnitude of damage area and extent observed on retrieved inserts, consistent with differences in the simulator's tibiofemoral contact mechanics and those known to occur in patients during functional activities. Modification of simulator inputs, such as the increased anteroposterior excursion and more severe loading conditions in Group W + S, can generate greater wear volume, larger damage areas, and increased surface deformation rates compared to standard inputs.
Databáze: OpenAIRE
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