title: Comparison of Tibial Insert Polyethylene Damage in Rotating Hinge and Highly Constrained Total Knee Arthroplasty: A Retrieval Analysis.
abstract: This study compared the damage scores and damage patterns in 19 tibial inserts from rotating hinge (RH) implants with 19 inserts from highly constrained (HC) implants. Each insert was divided into 16 damage zones and each zone was subjectively graded from a scale of 0-3 for seven different damage modes. The overall damage scores were comparable for the two groups (RH: 64.1 ± 15.4; HC: 66.1 ± 29.0; P = 0.59). The HC group, however, had greater post damage (compared to the post-hole of RH) while the RH group had greater backside damage. The pattern of damage was also different, with burnishing and cold flow being more common in HC group while pitting, scratching and embedded debris were more common in the RH group.
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Kamal
authors.initials: K
authors.lastname: Bali
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Naudie
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: James L
authors.initials: JL
authors.lastname: Howard
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCalden
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: MacDonald
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Surgical Innovation Program, Lawson Health Research Institute, London, ON, Canada.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Teeter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020959:Polyethylene / Q000737:chemistry*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D013977:Tibia / Q000601:surgery*
chemical_list: D020959:Polyethylene
keywords: constrained liner; damage; instability; polyethylene wear; rotating hinge