The influence of malalignment and ageing following sterilisation by gamma irradiation in an inert atmosphere on the wear of ultra-high-molecular-weight polyethylene in patellofemoral replacements

被引:4
作者
Maiti, Raman [1 ]
Cowie, Raelene M. [1 ]
Fisher, John [1 ]
Jennings, Louise M. [1 ]
机构
[1] Univ Leeds, Inst Med & Biol Engn, Leeds LS2 9JT, W Yorkshire, England
基金
英国工程与自然科学研究理事会; 英国惠康基金;
关键词
Knee prostheses; patellofemoral joint; wear; arthroplasty; in vitro; TOTAL KNEE ARTHROPLASTY; BIOLOGICAL-ACTIVITY; TOTAL HIP; KINEMATICS; DESIGN;
D O I
10.1177/0954411917696112
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Complications of patellofemoral arthroplasty often occur soon after implantation and, as well as other factors, can be due to the design of the implant or its surgical positioning. A number of studies have previously considered the wear of ultra-high-molecular-weight polyethylene patellae following suboptimal implantation; however, studies have primarily been carried out under a limited number of degrees of freedom. The aim of this study was to develop a protocol to assess the wear of patellae under a malaligned condition in a six-axis patellofemoral joint simulator. The malalignment protocol hindered the tracking of the patella centrally in the trochlear groove and imparted a constant 5 degrees external rotation (tilt) on the patella button. Following 3 million cycles of wear simulation, this condition had no influence on the wear of ultra-high-molecular-weight polyethylene patellae aged for 4 years compared to well-positioned non-aged implants (p > 0.05). However, under the malaligned condition, ultra-high-molecular-weight polyethylene patellae aged 8-10 years after unpacking (following sterilisation by gamma irradiation in an inert atmosphere) and worn ultra-high-molecular-weight polyethylene components also aged 4 years after unpacking (following the same sterilisation process) exhibited a high rate of wear. Fatigue failure due to elevated contact stress led to delamination of the ultra-high-molecular-weight polyethylene and in some cases complete failure of the patellae. The results suggest that suboptimal tracking of the patella in the trochlear groove and tilt of the patella button could have a significant effect on the wear of ultra-high-molecular-weight polyethylene and could lead to implant failure.
引用
收藏
页码:634 / 642
页数:9
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