Purpose: The aim of this study was to evaluate the clinical outcome and survival rate after isolated liner exchange for polyethylene (PE) wear in well-fixed metal-backed fixed-bearing unicompartmental knee arthroplasty (UKA).
Methods: Twenty medial UKAs in 19 patients [mean age 68.7 years ± 8.7 (range 48.5-81.5 years)] operated on for a direct PE liner exchange after isolated PE wear between 1996 and 2010 in two institutions were retrospectively reviewed. The mean delay between the index operation and revision was 8.2 years ± 2.6 (range 4.8-12.8 years). A four-level satisfaction questionnaire was used, and clinical outcomes were assessed using Knee Society scores (KSS) and range of motion (ROM) evaluation. Radiological evaluation analysed the position of the implants and progression of the disease. Survival rate of the implants was evaluated using Kaplan-Meier analysis with two different end-points.
Results: At the last follow-up [mean 6.8 years ± 5.2 (range 1.1-15.9 years)], 15 patients (79 %) were enthusiastic or satisfied. KSS improved from 73.4 to 86.4 points (p = 0.01) and function from 58.9 to 89.2 points (p < 0.001). ROM at last FU was 126.5° ± 10.3°. The survival rate at 12 years considering "revision for any reason" as the end-point was 71.3 ± 15.3 %, and the survival rate at 12 years considering "revision of UKA to TKA" as the end-point was 93.3 ± 6.4 %.
Conclusion: Isolated liner exchange for PE wear in well-fixed metal-backed fixed-bearing UKA represents a valuable treatment option in selective patients with durable improvement of clinical outcomes without compromising any future revision.
Level Of Evidence: Retrospective therapeutic study, Level IV.
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http://dx.doi.org/10.1007/s00167-014-3392-8 | DOI Listing |
J Mech Behav Biomed Mater
January 2025
Division of Orthopaedic Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. Electronic address:
Background: The risk of early revision of total hip arthroplasty (THA) for polyethylene wear is now low, but there remains a need to perform wear measurements in patients for clinical surveillance. The gold standard of wear measurements has been radiostereometric analysis (RSA), which has limited availability. The use of computed tomography (CT) to perform THA wear measurement was described a decade ago and found to have acceptable accuracy and precision, but high radiation dose was a concern.
View Article and Find Full Text PDFBiomedicines
January 2025
Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nish-7, Kita-ku, Sapporo 060-8638, Japan.
Periprosthetic osteolysis is the primary cause of arthroplasty failure in the majority of patients. Mechanistically, wear debris released from the articulating surfaces of a prosthesis initiates local inflammation and several modes of regulated cell death programs, such as ferroptosis, which represents a promising therapeutic target in various chronic inflammatory diseases. Thus, the current study aimed at exploring the therapeutic potential of targeting ferroptosis in a polyethylene-wear-debris-induced osteolysis model.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Orthopaedics, Liaocheng People's Hospital, Liaocheng, Shandong, P.R. China.
Background: Vitamin E-diffused highly cross-linked polyethylene (HXLPE/Vit E) is a relatively advanced material used in total hip arthroplasty (THA) but whether it shows superiority is unclear.
Objective: This meta-analysis was performed to investigate the effect of HXLPE/Vit E liners in THA.
Methods: Medline/PubMed, Embase and Cochrane Library databases were searched to retrieve studies assessing the efficacy of HXLPE/Vit E liners in THA with the design of a randomized, controlled trial.
Environ Res
January 2025
Southern California Coastal Water Research Project, Costa Mesa, CA, 92626, United States.
The concentration, character, and distribution of microplastics in coastal marine environments remain poorly understood, with most research focusing on the abundance of microplastics at the sea surface. To address this gap, we conducted one of the first comprehensive assessments of microplastic distribution through the marine water column and benthic sediment during the wet and dry season in the coastal waters of the San Pedro Bay Southern California, USA. Microplastic concentrations in the water column did not vary significantly across season but were significantly higher in nearshore environments and at the surface of the water column.
View Article and Find Full Text PDFArthroplast Today
December 2024
Hospital Pavia Arecibo, Arecibo Orthopedic Institute, Arecibo, PR, USA.
Synovial fistula of the knee occurs when a defect in the joint capsule creates a connection between skin, bursa, and a near tissue, manifesting as an opening with continuous draining fluid or a cyst. This is a case of an 80-year-old male who developed a synovial fistula with cystic presentation 6 years after the primary total knee arthroplasty. Management included a total knee arthroplasty revision surgery with intraoperative identification of the fistula with methylene blue, and using a gelatin-thrombin matrix for closure.
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