Skip to main content

Advertisement

SpringerLink
Log in

No higher tibial post fracture rate with highly cross-linked polyethylene inserts in total knee arthroplasty at a minimum 10-year follow-up

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to assess tibial post fracture between highly cross-linked polyethylene (HXPE) and conventional polyethylene inserts in consecutive posterior-stabilized (PS) total knee arthroplasty (TKA) over a minimum 10-years follow-up period.

Methods

Between July 2008 and December 2011, a consecutive series of 3264 primary TKAs was performed in 2098 patients using a PS total knee prosthesis at a single institution. The final cohort was classified into the HXPE group (792 cases) and the conventional group (2113 cases) according to insert material used during the procedure.

Results

The mean follow-up period was 11.4 years in the HXPE group and 11.8 years in the conventional group. Both cases of tibial post fracture occurred in the HXPE group, a complication rate of 0.25%. These two cases required replacement with a thicker tibial insert with retention of the femoral and tibial components. There were no cases of tibial post fracture in the conventional group.

Conclusion

There was no difference in tibial post fracture rate between the HXPE group and the conventional group in PS TKA on long-term follow-up.

Level of evidence

IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Availability of data and material

All data generated or analysed during this study are included in this published article.

References

  1. Abdeen AR, Collen SR, Vince KG (2010) Fifteen-year to 19-year follow-up of the Insall-Burstein-1 total knee arthroplasty. J Arthroplasty 25(2):173–178. https://doi.org/10.1016/j.arth.2009.01.009

    Article  PubMed  Google Scholar 

  2. Lachiewicz PF, Soileau ES (2009) Fifteen-year survival and osteolysis associated with a modular posterior stabilized knee replacement. A concise follow-up of a previous report. J Bone Joint Surg Am 91(6):1419–1423. https://doi.org/10.2106/JBJS.H.01351

    Article  PubMed  Google Scholar 

  3. Dolan MM, Kelly NH, Nguyen JT, Wright TM, Haas SB (2011) Implant design influences tibial post wear damage in posterior-stabilized knees. Clin Orthop Relat Res 469(1):160–167. https://doi.org/10.1007/s11999-010-1515-1

    Article  PubMed  Google Scholar 

  4. Lachiewicz PF (2011) How to treat a tibial post fracture in total knee arthroplasty? A systematic review. Clin Orthop Relat Res 469(6):1709–1715. https://doi.org/10.1007/s11999-010-1609-9

    Article  PubMed  Google Scholar 

  5. Jung KA, Lee SC, Hwang SH, Kim SM (2008) Fracture of a second-generation highly cross-linked UHMWPE tibial post in a posterior-stabilized scorpio knee system. Orthopedics 31(11):1137. https://doi.org/10.3928/01477447-20081101-10

    Article  PubMed  Google Scholar 

  6. Baek JH, Lee SC, Choi K, Nam CH (2022) High rate of tibial post-fracture in highly cross-linked polyethylene compared to conventional polyethylene in posterior-stabilized total knee arthroplasty at a minimum 12-year follow-up. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-022-06901-y. (Online ahead of print)

    Article  PubMed  Google Scholar 

  7. Diamond OJ, Howard L, Masri B (2018) Five cases of tibial post fracture in posterior stabilized total knee arthroplasty using Prolong highly cross-linked polyethylene. Knee 25(4):657–662. https://doi.org/10.1016/j.knee.2018.05.005

    Article  PubMed  Google Scholar 

  8. Baek JH, Lee SC, Choi K, Ahn HS, Nam CH (2021) Long-term survivorship of total knee arthroplasty with a single-radius, high-flexion posterior stabilized prosthesis. Knee 30:275–282. https://doi.org/10.1016/j.knee.2021.04.017

    Article  PubMed  Google Scholar 

  9. Bajada S, Searle D, Toms AD (2019) Ten-year results for a single-surgeon series of Scorpio non-restrictive geometry (NRG) posterior stabilised (PS) total knee replacement. Eur J Orthop Surg Traumatol 29(7):1533–1538. https://doi.org/10.1007/s00590-019-02456-w

    Article  PubMed  Google Scholar 

  10. Luo Z, Luo Z, Wang H, Xiao Q, Pei F, Zhou Z (2019) Long-term results of total knee arthroplasty with single-radius versus multi-radius posterior-stabilized prostheses. J Orthop Surg Res 14(1):139. https://doi.org/10.1186/s13018-019-1183-0

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kester MA, Herrera L, Wang A, Essner A (2007) Knee bearing technology: where is technology taking us? J Arthroplasty 22:16–20. https://doi.org/10.1016/j.arth.2007.05.012

    Article  PubMed  Google Scholar 

  12. Sharkey PF, Lichstein PM, Shen C, Tokarski AT, Parvizi J (2014) Why are total knee arthroplasties failing today–has anything changed after 10 years? J Arthroplasty 29(9):1774–1778. https://doi.org/10.1016/j.arth.2013.07.024

    Article  PubMed  Google Scholar 

  13. Jung KA, Lee SC, Hwang SH, Kim SM (2009) Fractured polyethylene tibial post in a posterior-stabilized knee prosthesis presenting as a floating palpable mass. J Knee Surg 22(4):374–376. https://doi.org/10.1055/s-0030-1247780

    Article  PubMed  Google Scholar 

  14. Lim HC, Bae JH, Hwang JH, Kim SJ, Yoon JY (2009) Fracture of a polyethylene tibial post in a Scorpio posterior-stabilized knee prosthesis. Clin Orthop Surg 1(2):118–121. https://doi.org/10.4055/cios.2009.1.2.118

    Article  PubMed  PubMed Central  Google Scholar 

  15. Shi X, Zhou Z, Shen B, Yang J, Kang P, Pei F (2015) Variations in morphological characteristics of prostheses for total knee arthroplasty leading to kinematic differences. Knee 22(1):18–23. https://doi.org/10.1016/j.knee.2014.10.013

    Article  PubMed  Google Scholar 

  16. Furman BD, Lipman J, Kligman M, Wright TM, Haas SB (2008) Tibial post wear in posterior-stabilized knee replacements is design-dependent. Clin Orthop Relat Res 466(11):2650–2655. https://doi.org/10.1007/s11999-008-0422-1

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kumar N, Yadav C, Raj R, Yadav S (2015) Fracture of the polyethylene tibial post in a posterior stabilized knee prosthesis: a case report and review of literature. J Orthop 12(3):160–163. https://doi.org/10.1016/j.jor.2015.01.002

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Joint and Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, 120, Sinmok-Ro, Yangcheon-Gu, Seoul, Republic of Korea

    Ji-Hoon Baek, Su Chan Lee, Hye Sun Ahn & Chang Hyun Nam

  2. Department of Orthopaedic Surgery, Himnaera Hospital, Busan, Republic of Korea

    Suengryol Ryu

Authors
  1. Ji-Hoon Baek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Su Chan Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Suengryol Ryu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hye Sun Ahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chang Hyun Nam
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chang Hyun Nam.

Ethics declarations

Conflict of interest

Each author certifies that he or she has no commercial association (e.g., consultancies, stock ownership, equity interest, patent, licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Ethical approval

This study was approved by the Institutional Review Board of Himchan hospital.

Informed consent

The requirement for informed consent was waived due to the retrospective nature of this study.

Consent to participate

The requirement for informed consent was waived due to the retrospective nature of this study.

Consent for publication

Authors agree to publication. This manuscript has not been published in any journal.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baek, JH., Lee, S.C., Ryu, S. et al. No higher tibial post fracture rate with highly cross-linked polyethylene inserts in total knee arthroplasty at a minimum 10-year follow-up. Arch Orthop Trauma Surg 143, 5807–5813 (2023). https://doi.org/10.1007/s00402-023-04789-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-023-04789-y

Keywords

Search

Navigation