Despite the long-term clinical and radiographic success that has been reported with total knee arthroplasty (TKA), failures related to the articular bearing surface continue to be one of the most significant factors that limit survivorship of TKA implants. Many variables influence wear and bearing surface failure,including factors related to the patient,the surgeon,and the implant. Future efforts should be directed at changes in the materials, implant design, sterilization methods, and surgical technique that could potentially lead to improvements in wear properties and an overall reduction in the incidence of bearing surface failures in TKA.


Total Knee Arthroplasty Wear Rate Contact Stress Total Knee Replacement Wear Debris 
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  1. 1.
    Ayers DC (2001) Maximizing ultra high molecular weight polyethylene performance in total knee replacement. Instr Course Lect 50:421–429PubMedGoogle Scholar
  2. 2.
    Ayers DC (1997) Polyethylene wear and osteolysis following total knee replacement. Instr Course Lect 46:205–213PubMedGoogle Scholar
  3. 3.
    Bartel DL, Bicknell VL, Wright TM (1986) The effect of conformity, thickness, and material on stresses in ultra-high molecular weight components for total joint replacement. J Bone Joint Surg [Am] 68:1041–1051PubMedGoogle Scholar
  4. 4.
    Bartel DL, Burstein AH, Toda MD, Edwards DL (1985) The effect of conformity and plastic thickness on contact stresses in metal-backed plastic implants. J Biomech Eng 107:193–199PubMedGoogle Scholar
  5. 5.
    Blunn G, Brach del Preva EM, Costa L, Fisher J, Freeman MA (2002) Ultra high molecular-weight polyethylene (UHMWPE) in total knee replacement: fabrication, sterilisation and wear. J Bone Joint Surg [Br] 84:946–949CrossRefGoogle Scholar
  6. 6.
    Bohl JR, Bohl WR, Postak PD, Greenwald AS (1999) The Coventry Award. The effects of shelf life on clinical outcome for gamma sterilized polyethylene tibial components. Clin Orthop 376:28–38CrossRefGoogle Scholar
  7. 7.
    Colizza WA, Insall JN, Scuderi GR (1995) The posterior stabilized total knee prosthesis. Assessment of polyethylene damage and osteolysis after a ten-year-minimum follow-up. J Bone Joint Surg [Am] 77:1713–1720PubMedGoogle Scholar
  8. 8.
    Collier JP, Sperling DK, Currier JH, et al (1996) Impact of gamma sterilization on clinical performance of polyethylene in the knee. J Arthroplasty 11:377–389CrossRefPubMedGoogle Scholar
  9. 9.
    Davis P, Bocell J, Tullos H (1999) Dissociation of the tibial component in total knee replacements. Clin Orthop 272:199–204Google Scholar
  10. 10.
    D’Lima DD, Chen PC, Colwell CW Jr (2001) Polyethylene contact stresses, articular congruity, and knee alignment. Clin Orthop 392:232–238PubMedGoogle Scholar
  11. 11.
    Faris PM, Ritter MA, Keating EM, Meding JB, Harty LD (2003) The AGC allpolyethylene tibial component: a ten-year clinical evaluation. J Bone Joint Surg [Am] 85:489–493PubMedGoogle Scholar
  12. 12.
    Goodman S, Lind M, Song Y, Smith R (1998) In vitro, in vivo and tissue retrieval studies on particulate debris. Clin Orthop 352:25–34PubMedGoogle Scholar
  13. 13.
    Howell G, Bourne R (2000) Osteolysis: etiology, prosthetic factors, and pathogenesis. Instr Course Lect 49:71–82PubMedGoogle Scholar
  14. 14.
    Jacobs J, Rosebuck K, Archibeck M, Hallab M, Glant T (2001) Osteolysis: basic science. Clin Orthop 393:71–77PubMedGoogle Scholar
  15. 15.
    Jacobs J, Shanbag A, Glant T, Black J, Galante J (1994) Wear debris in total joint replacements. J Am Acad Orthop Surgeons 2: 212–220Google Scholar
  16. 16.
    Kurtz SM, Bartel DL, Rimnac CM (1998) Postirradiation aging affects stress and strain in polyethylene components. Clin Orthop 350:209–220PubMedGoogle Scholar
  17. 17.
    Li S, Scuderi G, Furman BD, et al (2002) Assessment of backside wear from the analysis of 55 retrieved tibial inserts. Clin Orthop 404:75–82PubMedGoogle Scholar
  18. 18.
    McKellop H, Campbell P, Park S-H, et al (1995) The origin of submicron polyethylene wear debris in total hip arthroplasty. Clin Orthop 311:3–20PubMedGoogle Scholar
  19. 19.
    Muratoglu OK, Mark A, Vittetoe DA, Harris WH, Rubash HE (2003) Polyethylene damage in total knees and use of highly cross-linked polyethylene. J Bone Joint Surg [Am] 85[Suppl 1]:S7–S13PubMedGoogle Scholar
  20. 20.
    Rao A, Engh G, Collier M, Lounici S (2002) Tibial interface wear in retrieved total knee components and correlations with modular insert motion. J Bone Joint Surg [Am] 84:1849–1855PubMedGoogle Scholar
  21. 21.
    Rao KS, Siddalinga Swamy MK (1989) Sensory recovery in the plantar aspect of the foot after surgical decompression of posterior tibial nerve. Possible role of steroids along with decompression. Lepr Rev 60: 283–287PubMedGoogle Scholar
  22. 22.
    Reeves EA, Barton DC, FitzPatrick DP, Fisher J (2000) Comparison of gas plasma and gamma irradiation in air sterilization on the delamination wear of the ultra-high molecular weight polyethylene used in knee replacements. Proc Inst Mech Eng [H] 214:249–255CrossRefGoogle Scholar
  23. 23.
    Ries MD (2004) Dissociation of the UHMWPE Insert from tibial baseplate in total knee arthroplasty. A case report. J Bone Joint Surg [Am] 86:1522–1524PubMedGoogle Scholar
  24. 24.
    Rodriguez J, Baez N, Rasquinha V, Ranawat C (2001) Metal-backed and allpolyethylene tibial components in total knee replacement. Clin Orthop 392:174–183PubMedGoogle Scholar
  25. 25.
    Sathasivam S, Walker PS (1998) Computer model to predict subsurface damage in tibial inserts of total knees. J Orthop Res 16: 564–571CrossRefPubMedGoogle Scholar
  26. 26.
    Schmalzried T, Callaghan J (1999) Wear in total hip and knee replacements. J Bone Joint Surg [Am] 81:115–136PubMedGoogle Scholar
  27. 27.
    Shaw J (1992) Angled bearing inserts in total knee arthroplasty. A brief technical note. J Arthroplasty 7:211–216CrossRefPubMedGoogle Scholar
  28. 28.
    Sinha R, Shanbhag A, Maloney W, Hasselman C, Rubash H (1998) Osteoylsis: cause and effect. Instr Course Lect 47:307–320PubMedGoogle Scholar
  29. 29.
    Surace M, Berzins A, Urban R, et al (2002) Backsurface wear and defmoration in polyethylene tibial inserts retrieved postmortem. Clin Orthop 40:14–23Google Scholar
  30. 30.
    Wasielewski RC (2002) The causes of insert backside wear in total knee arthroplasty. Clin Orthop 404:232–246PubMedGoogle Scholar
  31. 31.
    Wasielewski RC, Galante JO, Leighty RM, Natarajan RN, Rosenberg AG (1994) Wear patterns on retrieved polyethylene tibial inserts and their relationship to technical considerations during total knee arthroplasty. Clin Orthop 299:31–43PubMedGoogle Scholar
  32. 32.
    Wasielewski RC, Parks N, Williams I, et al (1997) Tibial insert undersurface as a contributing source of polyethylene wear debris. Clin Orthop 345:53–59CrossRefPubMedGoogle Scholar
  33. 33.
    White SE, Paxson RD, Tanner MG, Whiteside LA (1996) Effects of sterilization on wear in total knee arthroplasty. Clin Orthop 331:164–171CrossRefPubMedGoogle Scholar
  34. 34.
    Willert H, Semlitsch M (1977) Reactions of the articular capsule to wear products of artificial joint prostheses. J Biomed Mater Res 11:157–164CrossRefPubMedGoogle Scholar
  35. 35.
    Williams IR, Mayor MB, Collier JP (1998) The impact of sterilization method on wear in knee arthroplasty. Clin Orthop 356:170–180CrossRefPubMedGoogle Scholar
  36. 36.
    Won CH, Rohatgi S, Kraay MJ, Goldberg VM, Rimnac CM (2000) Effect of resin type and manufacturing method on wear of polyethylene tibial components. Clin Orthop 376:161–171CrossRefPubMedGoogle Scholar
  37. 37.
    Wright T, Rimnac C, Faris P, Bansal M (1988) Analysis of surface damage in retrieved carbon fiber-reinforced and plain polyethylene tibial components from posterior stabilized total knee replacements. J Bone Joint Surg [Am] 70:1312–1319PubMedGoogle Scholar
  38. 38.
    Wright TM, Bartel DL (1986) The problem of surface damage in polyethylene total knee components. Clin Orthop 205:67–74PubMedGoogle Scholar

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© Springer Medizin Verlag Heidelberg 2005

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  • K. J. Bozic

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