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Flat-on-flat, nonconstrained, compression molded polyethylene total knee replacement

M A Ritter1, R Worland, J Saliski

  • 1Center for Hip and Knee Surgery, Mooresville, IN, USA.

Clinical Orthopaedics and Related Research
|December 1, 1995
PubMed
Summary
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This study found that Anatomical Graduated Components total knee arthroplasties with compression molded polyethylene tibial components achieved a 98% survival rate at 10 years. The flat-on-flat tibial design is believed to be key to this success.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Medical Device Engineering

Background:

  • Flat-on-flat, posterior cruciate ligament-sparing total knee prostheses have faced challenges with wear and loosening.
  • Previous designs necessitated multiple modifications, indicating areas for improvement in total knee arthroplasty (TKA).

Purpose of the Study:

  • To evaluate the long-term clinical and radiographic outcomes of Anatomical Graduated Components (AGC) total knee arthroplasties.
  • To assess the survival rate and identify failure modes of AGC TKAs with specific tibial component design.

Main Methods:

  • A retrospective review of 2001 AGC TKAs performed between 1983 and 1991 across three institutions.
  • Clinical and radiographic evaluations were conducted every 2-3 years, with 71 knees followed for over 10 years.

Related Experiment Videos

  • Failure analysis focused on revision causes, including tibial, femoral, and polyethylene dissociation issues.

    • Main Results:

    • A 98% survival rate was observed at the 10-year follow-up mark.
    • Eight failures required revision surgery: 5 tibial, 2 due to metalosis from patellar polyethylene dissociation, and 3 femoral.
    • The compression-molded, nonmodular polyethylene tibial components in a flat-on-flat design were associated with successful outcomes.

    Conclusions:

    • The Anatomical Graduated Components total knee arthroplasty, utilizing a flat-on-flat, compression-molded polyethylene tibial design, demonstrates excellent long-term survivorship.
    • This specific tibial component design appears to mitigate common TKA failure modes like wear and loosening.
    • Further investigation into the material properties and design principles of this successful tibial component is warranted.