scholarly journals Failure due to metallosis after cruciate retaining total knee replacement

2021 ◽  
Vol 13 (4) ◽  
pp. 75-78
Author(s):  
Ebied Wessam ◽  
Maziad Ali ◽  
Ahmed Nageeb Mahmoud
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Surgery ◽  
Polyethylene Wear ◽  
Base Plate ◽  
Metal Debris ◽  
Cruciate Retaining ◽  
Fluid Analysis ◽  
Metal Metal ◽  
Total Knee

Background: Rupture of PCL on cruciate retaining TKA can cause abnormal accelerated wear of polyethylene component which may result in metal/metal articulation and development of massive infiltration of metal debris in the periprosthetic soft tissue (metallosis). Patient and methods: Eight cases (Five females, 3 males, mean age 64.6 years) with failed primary cruciate retaining knee arthroplasty were retrospectively studied. Revisions were performed after a mean of 59.8 months due to pain and instability. All the patients had variable degrees of clinically relevant posterior knee instability. Infection was excluded in all cases through microbiological examination and synovial fluid analysis. Results: Abnormal direct metal-on-metal articulation between the femoral component and the tibial base plate with advanced polyethylene wear were found intraoperatively in all cases in addition to extensive tissues black staining, advanced osteolysis and pseudotumor formation. All cases were managed by single stage revision surgery with implant removal, profound synovectomy and revision using a more constrained modular revision knee system. Conclusion: Metallosis after total knee arthroplasty is a rare situation that should be suspected in total knee arthroplasty cases with radiologically evident advanced polyethylene wear especially in cruciate retaining knee systems. It could lead to significant osteolysis making revision surgery technically challenging.

Posterior cruciate–retaining modular total knee arthroplasty

2002 ◽  
Vol 17 (8) ◽  
pp. 961-966 ◽  
Author(s):  
Gary B. Fetzer ◽  
John J. Callaghan ◽  
Jesse E. Templeton ◽  
Devon D. Goetz ◽  
Patrick M. Sullivan ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Cruciate Retaining ◽  
Total Knee

Polyethylene Wear Particles in Synovial Fluid After Total Knee Arthroplasty

2003 ◽  
Vol 410 ◽  
pp. 165-172 ◽  
Author(s):  
Yukihide Minoda ◽  
Akio Kobayashi ◽  
Hiroyoshi Iwaki ◽  
Masatsugu Miyaguchi ◽  
Yoshinori Kadoya ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Synovial Fluid ◽  
Knee Arthroplasty ◽  
Polyethylene Wear ◽  
Wear Particles ◽  
Total Knee

Conforming Polyethylene Inserts in Total Knee Arthroplasty: Beyond the Posterior-Stabilized and Cruciate-Retaining Debate

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nathanael D. Heckmann ◽  
Thomas Steck ◽  
Scott M. Sporer ◽  
R. Michael Meneghini
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Total Knee

Isolated tibial insert exchange in revision total knee arthroplasty

2021 ◽  
Vol 103-B (6) ◽  
pp. 1103-1110
Author(s):  
Matthew W. Tetreault ◽  
Jeremy T. Hines ◽  
Daniel J. Berry ◽  
Mark W. Pagnano ◽  
Robert T. Trousdale ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Polyethylene Wear ◽  
Revision Total Knee Arthroplasty ◽  
Common Reason ◽  
Original Diagnosis ◽  
Tibial Insert ◽  
Total Knee ◽  
Component Loosening ◽  
Revision Tka

Aims This study aimed to determine outcomes of isolated tibial insert exchange (ITIE) during revision total knee arthroplasty (TKA). Methods From 1985 to 2016, 270 ITIEs were performed at one institution for instability (55%, n = 148), polyethylene wear (39%, n = 105), insert fracture/dissociation (5%, n = 14), or stiffness (1%, n = 3). Patients with component loosening, implant malposition, infection, and extensor mechanism problems were excluded. Results Survivorship free of any re-revision was 68% at ten years. For the indication of insert wear, survivorship free of any re-revision at ten years was 74%. Re-revisions were more frequent for index diagnoses other than wear (hazard ratio (HR) 1.9; p = 0.013), with ten-year survivorships of 69% for instability and 37% for insert fracture/dissociation. Following ITIE for wear, the most common reason for re-revision was aseptic loosening (33%, n = 7). For other indications, the most common reason for re-revision was recurrence of the original diagnosis. Mean Knee Society Scores improved from 54 (0 to 94) preoperatively to 77 (38 to 94) at ten years. Conclusion After ITIE, the risk and reasons for re-revision correlated with preoperative indications. The best results were for polyethylene wear. For other diagnoses, the re-revision rate was higher and the failure mode was most commonly recurrence of the original indication for the revision TKA. Cite this article: Bone Joint J 2021;103-B(6):1103–1110.

Comparison of Posterior-Cruciate Retaining versus Substituting P.F.C. Total Knee Arthroplasty (A Randomized Study)

2008 ◽  
Vol 43 (5) ◽  
pp. 631
Author(s):  
Churl Hong Chun ◽  
Jeong Woo Kim ◽  
Hyun Jun Kim ◽  
Chul Min Lim ◽  
Kwang Mee Kim
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Randomized Study ◽  
Cruciate Retaining ◽  
Total Knee

Biomechanical Effects of Kneeling With Posterior Cruciate Retaining and Posterior Cruciate Substituting Total Knee Arthroplasty

2009 ◽  
Author(s):  
Jason K. Hofer ◽  
Ryuichi Gejo ◽  
Michelle H. McGarry ◽  
Thay Q. Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Activities Of Daily Living ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Daily Living ◽  
Middle Eastern ◽  
Large Role ◽  
Asian Countries ◽  
Cruciate Retaining ◽  
Total Knee

Kneeling is an activity that is important in certain occupations and recreational activities. Culturally, kneeling plays a large role in Middle Eastern and Asian countries, where activities of daily living require the ability to kneel and achieve deep knee flexion.

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