PE wear in ceramic/PE bearing surface in total knee arthroplasty: Clinical experiences of more than 24 years

Abstract

We started to use a combination of alumina ceramic and ultra-high molecular weight polyethylene (UHMWPE) for total knee prostheses (TKP) in the late 1970s based on our good clinical results in total hip prostheses as well as the results of knee joint simulator tests. From 1982 to 1985, we operated 137 patients with TKP, which were mainly alumina/UHMWPE-typed. Since 1990, cemented alumina or zirconia ceramic/UHMWPE TKP have been used for more than 530 patients. In this study, we report the results of worn surface observation and the clinical wear with respect to the retrieved metallic TKP. The results of metal/UHMWPE bearing surface in TKP were compared with our clinical results of ceramic/UHMWPE one, in order to examine the efficacy of ceramic bearing surface in TKP. In the SEM observations, many scratches due to clinical use were observed on the retrieved metallic femoral component only. The scratching damage on the articulating surface was linear, which was produced by plowing of microscopic asperities on the opposite metallic surface. From clinical results and observations of the retrieved bearing surfaces, ceramic/UHMWPE TKP is superior to metal/UHMWPE TKP.