No difference in in vivo polyethylene wear particles between oxidized zirconium and cobalt–chromium femoral component in total knee arthroplasty

Abstract Background: The utility of a bi-cruciate retaining total knee arthroplasty (BCR-TKA) is uncertain. In this study, we performed an in vivo kinematic analysis of squat motion on level ground and on a downward slope in patients treated with BCR-TKA to examine the value of anterior cruciate ligament (ACL) preservation.Methods: The subjects were ten valgus knees that underwent TKA (BCR: 5 knees, CR: 5 knees) at our hospital. We evaluated in vivo kinematics of the knee using fluoroscopy and investigated the femoral component translation relative to the tibial component from extension to maximum flexion, and the rotation angle between the components under the two conditions. Statistical analysis was conducted by Mann-Whitney U test to compare the rotational angle, the location of lateral and medial contact points per flexion angle. Differences in these parameters between the BCR and CR groups across the flexion angles were compared by repeated measures ANOVA.Results: Rotation of the femoral component to the tibial component occurred gradually as flexion continued. On level ground, lateral rotation at 0° to 120° flexion was 14.5±1.95° in the BCR group and 7.9±0.47° in the CR group. Medial translation was 4.1±1.73mm in the BCR group and 2.5±1.64mm in the CR group, and lateral translation was 13.2±1.6mm in the BCR group and 7.1±1.74mm in the CR group. On a forward slope, lateral rotation was 12.7±1.45° in the BCR group and 7.57±0.47° in the CR group. Medial translation was 5.87±1.78mm in the BCR and 2.9±0.81mm in the CR, and lateral translation was 13.6±1.84mm in the BCR and 7.4±0.96mm in the CR.Conclusion: An in vivo kinetics analysis of deep flexion motion was conducted on level ground and on a forward slope to stress the ACL. Under both conditions, kinetics close to screw home movement were found in the BCR group and rotation was significantly larger than that in the CR group. The medial contact point between components was located significantly more anterior in the BCR group. In conclusion, BCR-TKA was found to have in vivo kinetics close to those of a normal knee, in comparison with CR-TKA.

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Accurate in vivo measurement of polyethylene wear in total knee arthroplasty

The Journal of Arthroplasty ◽

10.1054/arth.2002.32172 ◽

2002 ◽

Vol 17 (4) ◽

pp. 490-496 ◽

Cited By ~ 19

Author(s):

Akiho Hoshino ◽

Yutaka Fukuoka ◽

Akimasa Ishida

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Polyethylene Wear ◽

In Vivo Measurement ◽

Total Knee

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Metal sensitivity in patients before and after total knee arthroplasty (TKA): comparison between ceramic surfaced oxidized zirconium and cobalt-chromium implants

Hypersensitivity ◽

10.7243/2052-594x-1-3 ◽

2013 ◽

Vol 1 (1) ◽

pp. 3 ◽

Cited By ~ 7

Author(s):

Atsushi Kitagawa ◽

Takaaki Chin ◽

Nobuhiro Tsumura ◽

Tetsushiro Iguchi

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Cobalt Chromium ◽

Metal Sensitivity ◽

Before And After ◽

Oxidized Zirconium ◽

Total Knee

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Vitamin E-infused highly cross-linked polyethylene did not reduce the number of in vivo wear particles in total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.102b11.bjj-2020-0413.r1 ◽

2020 ◽

Vol 102-B (11) ◽

pp. 1527-1534

Author(s):

Kumi Orita ◽

Yukihide Minoda ◽

Ryo Sugama ◽

Yoichi Ohta ◽

Hideki Ueyama ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Vitamin E ◽

Polyethylene Wear ◽

Wear Particle ◽

Particle Analysis ◽

Wear Particles ◽

Wear Particle Analysis ◽

Total Knee

Aims Vitamin E-infused highly cross-linked polyethylene (E1) has recently been introduced in total knee arthroplasty (TKA). An in vitro wear simulator study showed that E1 reduced polyethylene wear. However there is no published information regarding in vivo wear. Previous reports suggest that newly introduced materials which reduce in vitro polyethylene wear do not necessarily reduce in vivo polyethylene wear. To assist in the evaluation of the newly introduced material before widespread use, we established an in vivo polyethylene wear particle analysis for TKA. The aim of this study was to compare in vivo polyethylene wear particle generation between E1 and conventional polyethylene (ArCom) in TKA. Methods A total of 34 knees undergoing TKA (17 each with ArCom or E1) were investigated. Except for the polyethylene insert material, the prostheses used for both groups were identical. Synovial fluid was obtained at a mean of 3.4 years (SD 1.3) postoperatively. The in vivo polyethylene wear particles were isolated from the synovial fluid using a previously validated method and examined by scanning electron microscopy. Results The total number of polyethylene wear particles obtained from the knees with E1 (mean 6.9, SD 4.0 × 107 counts/knee) was greater than that obtained from those with ArCom (mean 2.2, SD 2.6 × 107 counts/knee) (p = 0.001). The particle size (equivalent circle of diameter) from the knees with E1 was smaller (mean 0.5 μm, SD 0.1) than that of knees with ArCom (mean 1.5, SD 0.3 μm) (p = 0.001). The aspect ratio of particles from the knees with E1 (mean 1.3, SD 0.1) was smaller than that with ArCom (mean 1.4, SD 0.1) (p < 0.001 ). Conclusion This is the first report of in vivo wear particle analysis of E1. E1 polyethylene did not reduce the number of in vivo polyethylene wear particles compared with ArCom in early clinical stage. Further careful follow-up of newly introduced E1 for TKA should be carried out. Cite this article: Bone Joint J 2020;102-B(11):1527–1534.

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