Particle size and morphology of UHMWPE wear debris in failed total knee arthroplasties--a comparison between mobile bearing and fixed bearing knees.
Osteolysis induced by ultrahigh molecular weight polyethylene wear debris has been recognized as the major cause of long-term failure in total joint arthroplasties. In a previous study, the prevalence of intraoperatively identified osteolysis during primary revision surgery was much higher in mobile bearing knee replacements (47%) than in fixed bearing knee replacements (13%). We postulated that mobile bearing knee implants tend to produce smaller sized particles. In our current study, we compared the particle size and morphology of polyethylene wear debris between failed mobile bearing and fixed bearing knees. Tissue specimens from interfacial and lytic regions were extracted during revision surgery of 10 mobile bearing knees (all of the low contact stress (LCS) design) and 17 fixed bearing knees (10 of the porous-coated anatomic (PCA) and 7 of the Miller/Galante design). Polyethylene particles were isolated from the tissue specimens and examined using both scanning electron microscopy and light-scattering analyses. The LCS mobile bearing knees produced smaller particulate debris (mean equivalent spherical diameter: 0.58 microm in LCS, 1.17 microm in PCA and 5.23 microm in M/G) and more granular debris (mean value: 93% in LCS, 77% in PCA and 15% in M/G).
Huang
Chun-Hsiung
CH
Department of Orthopaedic Surgery, Mackay Memorial Hospital, Taipei, Taiwan. chhuang@ms2.mmh.org.tw
Ho
Fang-Yuan
FY
Ma
Hon-Ming
HM
Yang
Chan-Tsung
CT
Liau
Jiann-Jong
JJ
Kao
Hung-Chan
HC
Young
Tai-Horng
TH
Cheng
Cheng-Kung
CK
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001672:Biocompatible Materials / Q000145:classification; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D010316:Particle Size; D011095:Polyethylenes / Q000145:classification; D011474:Prosthesis Design; D011475:Prosthesis Failure
D001672:Biocompatible Materials; D011095:Polyethylenes; C111601:ultra-high molecular weight polyethylene