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Modular Polyethylene Inserts for Total Knee Arthroplasty: Can Surgeons Detect 1-mm Thickness Increments?
Joanne Y Yoo1, Jenny Cai1, Antonia F Chen1
1Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
The Journal of Arthroplasty
|January 4, 2016
Summary
Surgeons could not consistently detect 1-mm polyethylene insert thickness changes during total knee arthroplasty. This limits the clinical usefulness of finer adjustments in knee implant surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Device Engineering
Background:
- Manufacturers offer polyethylene (PE) inserts with 1-mm thickness increments for precise total knee arthroplasty (TKA) adjustments.
- This innovation aims to refine TKA kinematics through finer control over implant thickness.
Purpose of the Study:
- To evaluate the reliability of surgeons in detecting subtle 1-mm changes in polyethylene insert thickness during TKA.
- To assess the practical clinical utility of 1-mm incremental PE inserts in TKA.
Main Methods:
- Eighty-eight TKAs were performed by two experienced surgeons using implants with 1-mm PE inserts.
- After selecting the optimal PE thickness, trial inserts (1-mm smaller, same size, 1-mm larger) were randomly chosen and tested to assess surgeon detection accuracy.
Main Results:
- Surgeons accurately determined insert thicknesses in only 62.5% of trials (P = .050).
- The study found that surgeons could not consistently and accurately detect 1-mm incremental changes in trial PE implant thickness.
Conclusions:
- The ability of surgeons to reliably discern 1-mm PE insert variations is limited.
- Further research is needed to evaluate the clinical usefulness of 1-mm incremental PE inserts in TKA.
