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Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v22.i1.40
pages 21-31

Measurements of Surface and Subsurface Damage in Retrieved Polyethylene Tibial Inserts of a Contemporary Design

Matthew G Teeter
Division of Orthopaedic Surgery, London Health Sciences Centre, London, Ontario, N6A 5A5, Canada
Jan-M. Brandt
Concordia Joint Replacement Group, Concordia Hip and Knee Institute, Winnipeg, MB, R2K 2M9, Canada
Douglas D. R. Naudie
Division of Orthopaedic Surgery, The University of Western Ontario, London, ON
Eric R. Bohm
Concordia Joint Replacement Group, Concordia Hip and Knee Institute, Winnipeg, MB, R2K 2M9, Canada
Richard W. McCalden
Division of Orthopaedic Surgery, London Health Sciences Centre, London, Ontario, N6A 5A5, Canada
David W. Holdsworth
Imaging Research Laboratories, Robarts Research Institute; Department of Medical Biophysics; Division of Orthopaedic Surgery, The University of Western Ontario

ABSTRACT

In the present study, surface and subsurface damage due to wear and creep in retrieved tibial inserts from the Genesis II total knee replacement (Smith & Nephew, Memphis, TN) are quantified. The utility of a number of recently validated micro-computed tomography (micro-CT) techniques for use in retrieval studies are also demonstrated. Sixteen inserts retrieved from patients after an implantation time from 0.5 to 86 months were examined. The inserts were scanned using micro-CT, and the three-dimensional surface deviations (corresponding to wear and creep) between the retrieved inserts and a reference geometry were determined. The subsurface of the inserts was also examined. Deviations within damage features were measured, and a surface deviation rate (mm/ year) was calculated from the length of implantation. No subsurface fatigue damage was found. The mean deviation within the most damaged regions of the articular surface was 0.115 ± 0.064 mm medially and 0.099 ± 0.061 mm laterally (p = 0.20). The mean articular deviation rate for inserts in vivo for more than 1 year was 0.049 mm/year and was reduced to 0.026 mm/year in inserts implanted for more than 4 years. Wear and creep of the Genesis II PE insert was comparable to reported values in other total knee replacements.