title: 2009 Knee Society Presidential Guest Lecture: Polyethylene wear in total knees.
abstract: Knee arthroplasties in young and active patients place a substantial increase in the lifetime tribological demand and potential for wear-induced osteolysis. Polyethylene materials have advanced in recent years, reducing the potential for oxidative degradation and delamination failure. It is timely to consider tribological design variables and their potential to reduce surface wear and the long-term risk of osteolysis. The influence of reduced cross shear in rotating platform mobile-bearing knee designs and reduced surface wear area in low conforming fixed-bearing knees has been investigated. A reduction in cross shear substantially reduced wear in both multidirectional pin-on-plate studies and in rotating platform mobile-bearing designs in knee simulator studies. A reduction in bearing surface contact area substantially reduced surface wear in multidirectional pin-on-plate simulations and in low conforming fixed-bearing knee designs in knee simulator studies. This offers potential for a paradigm shift in knee design predicated by enhanced mechanical properties of new polymer materials. We describe two distinct low-wearing tribological design solutions: (1) a rotating platform design solution with reduced cross shear provides reduced wear with conformity and intrinsic stability; and (2) a low conformity fixed bearing with reduced surface area, provides reduced wear, but has less intrinsic stability and requires good soft tissue function.
authors: Institute for Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK. J.fisher@Leeds.ac.uk
authors: John
authors: J
authors: Fisher
authors: Louise M
authors: LM
authors: Jennings
authors: Alison L
authors: AL
authors: Galvin
authors: Zhongmin M
authors: ZM
authors: Jin
authors: Martin H
authors: MH
authors: Stone
authors: Eileen
authors: E
authors: Ingham
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D019544:Equipment Failure Analysis / Q000379:methods*; D006801:Humans; D007720:Knee Prosthesis; D008422:Materials Testing / Q000379:methods*; D008875:Middle Aged; D020959:Polyethylene / Q000737:chemistry*; D011474:Prosthesis Design / Q000379:methods*; D011475:Prosthesis Failure
chemical_list: D020959:Polyethylene