Peri-Implant Distribution of Polyethylene Debris in Postmortem-Retrieved Knee Arthroplasties: Can Polyethylene Debris Explain Loss of Cement-Bone Interlock in Successful Total Knee Arthroplasties?

Karen I Cyndari; Jacklyn R Goodheart; Mark A Miller; Megan E Oest; Timothy A Damron; Kenneth A Mann

doi:10.1016/j.arth.2017.01.047

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Peri-Implant Distribution of Polyethylene Debris in Postmortem-Retrieved Knee Arthroplasties: Can Polyethylene Debris Explain Loss of Cement-Bone Interlock in Successful Total Knee Arthroplasties?

Journal article

Peer reviewed

Peri-Implant Distribution of Polyethylene Debris in Postmortem-Retrieved Knee Arthroplasties: Can Polyethylene Debris Explain Loss of Cement-Bone Interlock in Successful Total Knee Arthroplasties?

Karen I Cyndari, Jacklyn R Goodheart, Mark A Miller, Megan E Oest, Timothy A Damron and Kenneth A Mann

The Journal of arthroplasty, Vol.32(7), pp.2289-2300

07/01/2017

DOI: 10.1016/j.arth.2017.01.047

PMCID: PMC5469692

PMID: 28285038

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Abstract

Loss of mechanical interlock between cement and bone with in vivo service has been recently quantified for functioning, nonrevised, cemented total knee arthroplasties (TKAs). The cause of interlocking trabecular resorption is not known. The goal of this study is to quantify the distribution of PE debris at the cement-bone interface and determine if polyethylene (PE) debris is locally associated with loss of interlock. Fresh, nonrevised, postmortem-retrieved TKAs (n = 8) were obtained en bloc. Laboratory-prepared constructs (n = 2) served as negative controls. The intact cement-bone interface of each proximal tibia was embedded in Spurr's resin, sectioned, and imaged under polarized light to identify birefringent PE particles. PE wear particle number density was quantified at the cement-bone interface and distal to the interface, and then compared with local loss of cement-bone interlock. The average PE particle number density for postmortem-retrieved TKAs ranged from 8.6 (1.3) to 24.9 (3.1) particles/mm (standard error) but was weakly correlated with years in service. The average particle number density was twice as high as distal (>5mm) to the interface compared to at the interface. The local loss of interlock at the interface was not related to the presence, absence, or particle density of PE. PE debris can migrate extensively along the cement-bone interface of well-fixed tibial components. However, the amount of local bone loss at the cement-bone interface was not correlated with the amount of PE debris at the interface, suggesting that the observed loss of trabecular interlock in these well-fixed TKAs may be due to alternative factors.

Adult

Aged

Aged, 80 and over

Arthroplasty, Replacement, Knee - adverse effects

Bone Cements

Bone Resorption

Bone-Implant Interface

Female

Humans

Knee - pathology

Male

Middle Aged

Polyethylene

Prostheses and Implants

Prosthesis Failure

Tibia - surgery

Details

Title: Subtitle: Peri-Implant Distribution of Polyethylene Debris in Postmortem-Retrieved Knee Arthroplasties: Can Polyethylene Debris Explain Loss of Cement-Bone Interlock in Successful Total Knee Arthroplasties?
Creators: Karen I Cyndari - SUNY Upstate Medical University
Jacklyn R Goodheart - SUNY Upstate Medical University
Mark A Miller - SUNY Upstate Medical University
Megan E Oest - SUNY Upstate Medical University
Timothy A Damron - SUNY Upstate Medical University
Kenneth A Mann - SUNY Upstate Medical University
Resource Type: Journal article
Publication Details: The Journal of arthroplasty, Vol.32(7), pp.2289-2300
DOI: 10.1016/j.arth.2017.01.047
PMID: 28285038
PMCID: PMC5469692
ISSN: 0883-5403
eISSN: 1532-8406
Grant note: F30 AR067570 / NIAMS NIH HHS R01 AR042017 / NIAMS NIH HHS
Language: English
Date published: 07/01/2017
Academic Unit: Emergency Medicine
Record Identifier: 9984696654002771

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