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Retrieval analysis of nonmodular constrained tibial inserts after primary total knee replacement
Douglas E Padgett1, Jocelyn Cottrell, Natalie Kelly
1Division of Adult Reconstruction and Joint Replacement, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA. padgettd@hss.edu
The Orthopedic Clinics of North America
|October 30, 2012
Summary
Constrained tibial inserts in primary total knee replacement showed significant damage. Relying on polyethylene posts for stability may lead to failure, suggesting soft tissue techniques are preferable.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Implant retrieval analysis
Background:
- Primary total knee replacement presents challenges with large angular deformities.
- Increased component constraint is sometimes used for stability in these cases.
Purpose of the Study:
- To assess the damage to retrieved constrained tibial inserts used in primary total knee arthroplasty.
- To identify the location and extent of damage on these implants.
Main Methods:
- Analysis of a consecutive series of retrieved constrained tibial inserts.
- Examination of post and articular surface damage.
Main Results:
- Significant post and articular surface damage were observed in the retrieved implants.
- Damage was associated with reliance on the polyethylene post for stability.
Conclusions:
- The polyethylene post in constrained tibial inserts may be a failure point.
- Prioritizing soft tissue techniques for implant stability in primary total knee replacement is recommended.