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Polished Trays Reduce Backside Wear Independent of Post Location in Posterior-stabilized TKAs

  • Basic Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Backside damage of the polyethylene in TKA is a potential source of debris. The location of the tibial post in posterior-stabilized implants may influence micromotion, and thus affect backside damage, as may surface roughness.

Questions

We used implant retrieval analysis to (1) examine if there were differences in backside damage among three modern posterior-stabilized implants attributable to variable surface roughness; (2) determine if the location of damage on the tibial post affected the pattern of backside damage; and (3) determine if demographics influenced backside damage.

Methods

We identified 403 posterior-stabilized tibial retrieved inserts (147 NexGen®, 152 Optetrak®, 104 Genesis® II). The damage on the surfaces of the tibial posts was previously graded. The backside of the inserts (divided into quadrants) were scored for evidence of damage. The total quadrant damage was compared for each implant group, the relationship between post face damage and location of damage on the backside was determined for each implant group, and total backside damage was compared among the three implant groups.

Results

No correlation was found between the location of damage on the post and location of damage on the backside of the implant for any of the three groups. The Genesis® II polyethylene implants, which articulate with a highly polished tibial tray, showed a significantly lower total backside damage score (p < 0.01) when compared with the other two implant groups. The Genesis® II and Optetrak® showed significantly more damage in the posterior quadrants of the implants (p < 0.01) when compared with the anterior quadrants. A linear regression analysis revealed that lower tibial tray surface roughness was correlated with decreased damage.

Conclusions

An implant design with a highly polished tibial tray was associated with decreased backside damage. However, tibial post design and location did not influence the location of backside damage.

Clinical Relevance

Our study showed that a highly polished tibial tray was associated with decreased damage to the backside of polyethylene inserts independent of post design and location. These findings should be taken into consideration when new generations of implants are designed.

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Author information

Authors and Affiliations

  1. Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Matthew P. Abdel MD, Mark W. Gesell MD, Christen W. Hoedt BS & Steven B. Haas MD

  2. Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA

    Kathleen N. Meyers MS & Timothy M. Wright PhD

Authors
  1. Matthew P. Abdel MD
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  2. Mark W. Gesell MD
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  3. Christen W. Hoedt BS
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  4. Kathleen N. Meyers MS
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  5. Timothy M. Wright PhD
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  6. Steven B. Haas MD
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Corresponding author

Correspondence to Matthew P. Abdel MD.

Additional information

One author certifies that he (SBH), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount in excess of USD 1,000,000 from Smith & Nephew, Inc (Memphis, TN, USA).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at the Hospital for Special Surgery, New York, NY, USA.

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Abdel, M.P., Gesell, M.W., Hoedt, C.W. et al. Polished Trays Reduce Backside Wear Independent of Post Location in Posterior-stabilized TKAs. Clin Orthop Relat Res 472, 2477–2482 (2014). https://doi.org/10.1007/s11999-014-3621-y

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  • DOI: https://doi.org/10.1007/s11999-014-3621-y

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