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Journal of Long-Term Effects of Medical Implants
SJR: 0.133 SNIP: 0.491 CiteScore™: 0.89

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

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2018025386
pages 79-85

Is Soft Tissue Laxity Associated with Tissue Metal Concentrations after Total Knee Arthroplasty?

Meredith Perkins
Department of Orthopedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN
Julie Lowell
Department of Orthopedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN
Christina Arnholt
Department of Biomedical Engineering, Drexel University, Philadelphia, PA
Daniel MacDonald
Department of Biomedical Engineering, Drexel University, Philadelphia, PA
Anita L. Kerkhof
Department of Orthopedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN; Campbell Clinic Orthopedics, Germantown, TN
Steven M. Kurtz
Department of Biomedical Engineering, Drexel University, Philadelphia, PA; Exponent Inc., Philadelphia, PA
William M. Mihalko
Department of Orthopedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN; Campbell Clinic Orthopedics, Germantown, TN

ABSTRACT

Increased joint laxity is associated with excessive polyethylene wear, but the correlation between laxity and metal wear has not been established. Fifteen necropsy-retrieved primary total knee replacements were mounted into a custom knee-testing machine that measured anterior–posterior, varus–valgus, and internal–external rotational laxity at 0°, 30°, 60°, and 90° of flexion. Inductively coupled plasma-mass spectrometry analysis was performed to measure the cobalt (Co), chromium (Cr), and titanium (Ti) concentrations in periprosthetic tissue samples. Spearman's rank correlations were performed to determine whether a significant correlation (p < 0.05) existed between soft tissue laxity and tissue metal concentrations. At 0° flexion, decreased posterior displacement was negatively correlated with elevated Co and Cr concentrations. At 30° flexion, decreased external rotation and varus deflection was negatively correlated with elevated Ti concentrations. At 60° flexion, decreased anterior displacement was negatively correlated with elevated Cr concentrations and decreased varus deflection was negatively correlated with increased Ti concentrations. At 90° flexion, decreased anterior displacement was negatively correlated with elevated Co and Cr concentrations. To our knowledge, this is the first study to investigate the correlation between tissue metal concentration and laxity. Decreased laxity was associated with elevated metal concentrations in periprosthetic tissue.


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