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Techniques and technologies in revision knee arthroplasty.

Leo A Whiteside1

  • 1Missouri Bone and Joint Center, Missouri Bone and Joint Research Foundation, St. Louis, Missouri 63131, USA.

The Journal of Arthroplasty
|August 25, 2007
PubMed
Summary
This summary is machine-generated.

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This study shows that isolated polyethylene liner exchange in total knee arthroplasty is a viable option for revision surgery. Most patients experienced good clinical function after the procedure, with no failures in fabricated locking mechanisms.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science

Background:

  • Total knee arthroplasty (TKA) is a common procedure for end-stage knee arthritis.
  • Polyethylene liner wear is a leading cause of TKA failure, necessitating revision surgery.
  • Isolated polyethylene exchange offers a less invasive revision option compared to complete TKA revision.

Purpose of the Study:

  • To present the clinical indications and surgical technique for isolated polyethylene component revision in TKA.
  • To evaluate the clinical outcomes and mechanical integrity of revised polyethylene liners in TKA.

Main Methods:

  • Retrospective evaluation of 46 patients (49 knees) undergoing isolated polyethylene liner exchange.
  • Assessment of femoral and tibial component alignment and fixation.
  • Fabrication of locking mechanisms using polymethylmethacrylate (PMMA) for designs without integrated locking.

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Main Results:

  • Good clinical function was achieved in 94% of knees following polyethylene exchange.
  • Existing locking mechanisms facilitated exchange in 13 knees.
  • Fabricated locking mechanisms were successfully implemented in 36 knees without failure.
  • No failures were reported for any of the fabricated locking mechanisms.

Conclusions:

  • Isolated polyethylene liner exchange is a clinically successful revision strategy for TKA.
  • A fabricated locking mechanism using PMMA is a reliable method for designs lacking integrated fixation.
  • This technique preserves well-fixed components, potentially reducing surgical morbidity.