PMID: 9429106Jan 16, 1998Paper

Polyethylene failure in New Jersey low-contact stress total knee arthroplasty

Journal of Biomedical Materials Research
C H HuangC K Cheng

Abstract

From January 1985 to December 1990, 598 consecutive New Jersey low-contact stress (LCS) total knee arthroplasties (TKAs) were performed for gonarthrosis. Among these 598 operations, 322 were with rotating platform elements and 276 were with meniscal bearing elements. During 5 to 8 years of follow-up, eight knees had severe symptomatic polyethylene failure that required revision surgery; all eight cases were meniscal bearing types. The failed polyethylene inserts were retrieved and studied. It was observed that there were four probable failure mechanisms associated with the catastrophic polyethylene wear. First, insufficient thickness of the meniscal bearing was the major reason for wear. Second, the malpositioning of the metal tibial tray in the transverse plane resulted in the breaking of the meniscal bearing. Third, the inability of the patellar to rotate due to tissue ingrowth made the polyethylene break. Last, yellowing of the subsurface of the meniscal bearing was a sign of polyethylene failure. These four possible failure mechanisms are all associated with the design of the meniscal bearing type of LCS knee prostheses. Therefore, it is suggested that the design of the LCS knee prosthesis should be modified.

References

Jul 1, 1979·Journal of Biomedical Materials Research·H J Nusbaum, R M Rose
Aug 1, 1985·Journal of Biomechanical Engineering·D L BartelD L Edwards
Nov 1, 1984·Journal of Biomedical Materials Research·P Eyerer, Y C Ke
Jul 1, 1994·The Journal of Bone and Joint Surgery. American Volume·C M RimnacT M Wright

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Citations

May 21, 2005·The Journal of Arthroplasty·Chun-Hsiung HuangCheng-Kung Cheng
Jan 6, 2007·Journal of Orthopaedic Surgery and Research·Chun-Hsiung HuangCheng-Kung Cheng
Jun 13, 2001·The Journal of Arthroplasty·C J LaverniaK Krackow
Dec 4, 2003·Clinical Orthopaedics and Related Research·Chun-Hsiung HuangFang-Yuan Ho
Dec 4, 2002·Clinical Orthopaedics and Related Research·Chun-Hsiung HuangCheng-Kung Cheng
May 31, 2001·Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine·V C JonesJ Fisher
Dec 12, 2003·The Journal of Bone and Joint Surgery. American Volume·Chun-Hsiung HuangHon-Ming Ma
Aug 5, 2004·Clinical Orthopaedics and Related Research·Neville W ThompsonJames B Stiehl
Nov 20, 2002·Clinical Orthopaedics and Related Research·Ray C Wasielewski
May 12, 2001·Clinical Orthopaedics and Related Research·D D D'LimaC W Colwell
Sep 11, 2007·Clinical Orthopaedics and Related Research·James M HartfordPaul J Nicholls

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