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Change in UHMWPE properties of retrieved ceramic total knee prosthesis in clinical use for 23 years

✍ Scribed by Hironobu Oonishi; Sok Chol Kim; Masayuki Kyomoto; Shingo Masuda; Taiyo Asano; Ian C. Clarke


Publisher
John Wiley and Sons
Year
2005
Tongue
English
Weight
775 KB
Volume
74B
Category
Article
ISSN
1552-4973

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✦ Synopsis


Abstract

The alumina–ceramic total knee prosthesis developed by Kyocera Corp. was implanted in 1979, and was in clinical use for 23 years until total knee arthroplasty revision surgery in January 2002. It is believed that this is the longest clinical period of a ceramic total knee prosthesis reported to date in the world. In the present study, we gave consideration to the long‐term clinical stability of the alumina–ceramic femoral component as well as the mechanism of in vivo degradation of ultrahigh molecular weight polyethylene (UHMWPE) based on the evaluated wear, oxidation, and fracture toughness of the retrieved UHMWPE. We concluded that the degradation of UHMWPE by progressive oxidation is an issue to be solved in the future. To moderate stress concentration, use of a thin UHMWPE insert should be avoided. The low wear rate and the mild wear pattern observed this time suggest the possibility of reduced wear of the UHMWPE against the alumina–ceramic femoral component, and the usefulness of the alumina–ceramic total knee prosthesis component was recognized even after long clinical use. © 2005 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2005