Knee Wear Measured in Retrievals: A Polished Tray Reduces Insert Wear
Knee Wear Measured in Retrievals: A Polished Tray Reduces Insert Wear
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DOI：
10.1007/s11999-012-2248-0
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发表时间：
2012-07-01
影响因子：
4.2
通讯作者：
Collier, John P.
中科院分区：
文献类型：
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作者：
Berry, Daniel J.;Currier, John H.;Collier, John P.
聚乙烯磨损通常被认为是TKA失败的原因。旋转平台（RP）膝关节在旋转表面上显示出明显的表面损伤，这引起了人们对与固定平台衬垫相比磨损增加的担忧。因此，我们解决了以下问题：与固定平台衬垫相比，RP衬垫的磨损是否增加？胫骨托的表面粗糙度是否对组配式膝关节的体内磨损有可测量的影响？后稳定型（PS）和交叉韧带保留型（CR）膝关节的磨损率是否不同？我们比较了两个系列的已回收膝关节器械的磨损：94个RP移动的关节面与抛光钴铬（CoCr）托盘，218个固定关节面与粗糙钛（Ti）和抛光CoCr托盘。RP和固定平台系列的最短植入时间分别为0.4个月（中位数，36个月;范围，0.4-124个月）和2个月（中位数，72个月;范围，2-179个月）。RP衬垫的磨损率低于固定平台衬垫。与抛光CoCr胫骨托匹配的固定平台胫骨衬垫的背面磨损率低于粗糙钛质胫骨托的胫骨衬垫。抛光胫骨托（RP或固定平台）的磨损率未随时间增加。PS膝关节的磨损率与CR膝关节相似。我们发现，与固定平台相比，移动的平台膝关节的磨损率降低，这可能是由于抛光的CoCr胫骨托表面。抛光CoCr胫骨托中的固定平台衬垫磨损低于粗糙钛胫骨托中的对应衬垫，抛光CoCr胫骨托中衬垫的磨损率似乎不会随时间增加。
Polyethylene wear is often cited as the cause of failure of TKA. Rotating platform (RP) knees show notable surface damage on the rotating surface raising concerns about increased wear compared to fixed bearing inserts.We therefore addressed the following questions: Is wear in RP inserts increased compared to that in fixed bearing inserts? Does the surface roughness of the tibial tray have a measurable impact on in vivo wear of modular knees? And does wear rate differ between posterior stabilized (PS) and cruciate retaining (CR) knees?We compared wear in two series of retrieved knee devices: 94 RP mobile bearings with polished cobalt-chrome (CoCr) trays and 218 fixed bearings with both rough titanium (Ti) and polished CoCr trays. Minimum implantation time was 0.4 months (median, 36 months; range, 0.4-124 months) and 2 months (median, 72 months; range, 2-179 months) for the RP and fixed bearing series, respectively.Wear rate was lower for RP inserts than for fixed bearing inserts. Backside wear rate was lower for fixed bearing inserts mated to polished CoCr trays than for inserts from rough Ti trays. Inserts against polished trays (RP or fixed bearing) showed no increase in wear rate increase over time. Wear rate of PS knees was similar to that of CR knees.We found mobile bearing knees have reduced wear rate compared to fixed bearings, likely due to the polished CoCr tibial tray surface. Fixed bearing inserts in polished CoCr trays wear less than their counterparts in rough Ti trays, and the wear rate of inserts from polished CoCr trays does not appear to increase with time.