MULTIPLE DAMAGE OF THE TIBIAL POLYETHYLENE INSERT IN KNEE JOINT PROSTHESIS (CAN EXCELLENT POSTOPERATIVE OUTCOME BE THE CAUSE OF FRACTURE OF THE TIBIAL INSERT?) CASE REPORT AND LITERATURE REVIEW

Cover Page


Cite item

Full Text

Abstract

Despite improvements in prosthesis technology and use of high-quality materials in recent years, the number of revisions related to implant failures (4.7%) remains high. Several phenomena were reported in literature as reasons for dislocation and fracture of tibial insert in mobile bearing prosthesis: incorrect positioning of components, discrepancy of extension and flexion balancing or ligament weakness. However, in our cases neither of these causes were observed. The authors consider that bio-physiological and biomechanical aspects of total knee arthroplasty and knee joint prosthesis should be thoroughly studied and implemented into the clinical practice. In the described cases, multiple damage of the insert due to flexion instability and “twist-hyperflexion” in overweight patients is perceived as the reason for failures.

About the authors

E. Song

Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, Seoul, Korea

Email: fake@neicon.ru
профессор Korea, Republic of

K. Eshnazarov

Department of Orthopaedic Surgery, Shinchon Yonsei Hospital, Seoul, Korea

Author for correspondence.
Email: kamolhuja77@mail.ru
Korea, Republic of

S. Asilova

Department of Traumatology, Orthopedics and Neurosurgery, Tashkent Medical Academy

Email: fake@neicon.ru
Uzbekistan

J. Seon

Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, Seoul, Korea

Email: fake@neicon.ru
Korea, Republic of

References

  1. Baker RP, Masri BA., Greidanus NV, Garbuz DS. Outcome after isolated polyethylene tibial insert exchange in revision total knee arthroplasty. J Arthroplasty. 2013; 28(1):1-6.
  2. Bansal A, Khatib ON, Zuckerman JD. Revision total joint arthroplasty: the epidemiology of 63,140 cases in New York State. J Arthroplasty. 2014; 29(1):23-27.
  3. Bozic KJ, Kurtz SM, Lau E et al. The epidemiology of revision total knee arthroplasty in the United States. Clin Orthop Relat Res. 2010; 468:45-51.
  4. Culliford D, Maskell J, Judge A, Cooper C, PrietoAlhambra D, Arden N et al. Future projections of total hip and knee arthroplasty in the UK: results from the UK. Clinical Practice Research Datalink. Osteoarthritis Cartilage. 2015; 23:594-600.
  5. Geiger F, Mau H, Krüger M et al. Comparison of a new mobile-bearing total knee prosthesis with a fixed-bearing prosthesis: a matched pair analysis. Arch Orthop Trauma Surg. 2008; 128:285.
  6. Gilbert SL, Rana AJ, Lipman JD, Wright TM, Westrich GH. Design changes improve contact patterns and articular surface damage in total knee arthroplasty. Knee. 2014; 21(6):1129-1134.
  7. Gøthesen Ø, Espehaug B, Havelin L et al. Survival rates and causes of revision in cemented primary total knee replacement: a report from the Norwegian arthroplasty register 1994–2009. Bone Joint J. 2013; 95(5):636-642.
  8. Hwang BH, Lee WS, Park KK et al. Anterior-posterior glide mobile-bearing total knee arthroplasty complications related to prosthesis design. J Arthroplasty. 2011; 26(8):1438-1444.
  9. In Y, Sur YJ, Won HY, Moon YS. Recurrent dissociation of the tibial insert after mini-subvastus posterior-stabilized total knee arthroplasty: a case report. Knee. 2011; 18(6):461-463.
  10. Kim TK, Chang CB, Kang YG, Chung BJ, Cho HJ, Seong SC. Early clinical outcomes of floating platform mobile bearing TKA: longitudinal comparison with fixed bearing TKA. Knee Surg Sports Traumatol Arthrosc. 2010; 18(7):879-882.
  11. Kumar N, Yadav C, Raj R, Yadav S. Fracture of the polyethylene tibial post in a posterior stabilized knee prosthesis: A case report and review of literature. J Orthopaedics. 2015; 12(3):160-163.
  12. Lee CS, Chen WM, Kou HC, Lo WH, Chen CL. Early nontraumatic fracture of the polyethylene tibial post in a NexGen LPS-Flex posterior stabilized knee prosthesis. J Arthroplasty. 2009; 24(8):1292-1292.
  13. Lee DH, Lee DK, Shin YS, Han SB. Mid-term outcomes of floating platform mobile-bearing total knee arthroplasty under navigational guidance with a minimum 4-year follow-up. J Arthroplasty. 2013; 28(10):1801-1805.
  14. Lockard CA, Sanders AP, Raeymaekers B. An experimental approach to determining fatigue crack size in polyethylene tibial inserts. J Mech Behavior Biomed Mater. 2015; 54:106-114.
  15. Maas A, Kim TK, Miehlke RK, Hagen T, Grupp TM. Differences in anatomy and kinematics in Asian and Caucasian TKA patients: influence on implant positioning and subsequent loading conditions in mobile bearing knees. BioMed Res Int. 2014, 2014; 2014:612838. doi: 10.1155/2014/612838.
  16. Pruitt LA. Deformation, yielding, fracture and fatigue behavior of conventional and highly cross-linked ultra high molecular weight polyethylene. Biomaterials. 2005; 26:905-915.
  17. Ridgeway S, Moskal JT. Early instability with mobilebearing total knee arthroplasty. A Series of 25 cases. J Arthroplasty. 2004; 19(6):686-693.
  18. Robertsson O, Knutson K, Lewold S, Lidgren L. The Swedish Knee Arthroplasty Register 1975–1997: an update with special emphasis on 41,223 knees operated on in 1988–1997. Acta Orthop Scand. 2001; 72(5):503-513.
  19. Rutten SGM, Janssen RPA. Spontaneous late dislocation of the high flexion tibial insert after Genesis II total knee arthroplasty. A case report. Knee. 2009; 16(5):409-411.
  20. Sadoghi P, Liebensteiner M, Agreiter M. et al. Revision surgery after total joint arthroplasty: a complicationbased analysis using worldwide arthroplasty registers. J Arthroplasty. 2013; 28(8):1329-1332.
  21. Shimagaki H, Bechtold JE, Sherman RE, Gustilo RB. Stability of initial fixation of the tibial component in cementless total knee arthroplasty. J Orthop Res. 1990; 8:64-71.
  22. Thompson NW, Wilson DS, Cran GW, Beverland DE, Stiehl JB. Dislocation of the rotating platform after low contact stress total knee arthroplasty. Clin Orthop Relat Res. 2004; 1:207-211.
  23. van Graan W, van der Merwe W. The influence of posterior condylar offset on maximum knee flexion: a retrospective analytical study. SA Orthop J. 2014; 13(1):65-68.
  24. Yoon JR, Jeong HI, Oh KJ, Yang JH.Bilateral condyle fracture of tibial insert in mobile bearing total knee arthroplasty. Knee. 2014; 21(1):318-321.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2016


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies