Cross-linked polyethylene does not reduce wear in total knee arthroplasty

S Lasurt-Bachs; P Torner; F Maculé; E Prats; F Menéndez-García; J Ríos-Guillermo; A Torrents

doi:10.1016/j.recot.2017.11.004

Cross-linked polyethylene does not reduce wear in total knee arthroplasty

Rev Esp Cir Ortop Traumatol (Engl Ed). 2018 May-Jun;62(3):197-203. doi: 10.1016/j.recot.2017.11.004. Epub 2018 Feb 14.

[Article in English, Spanish]

Authors

S Lasurt-Bachs¹, P Torner², F Maculé³, E Prats⁴, F Menéndez-García⁵, J Ríos-Guillermo⁶, A Torrents⁶

Affiliations

¹ Unitat de Genoll, Servei de Cirurgia Ortopèdica i Traumatologia, Consorci Sanitari Integral Baix Llobregat, Universitat de Barcelona, Barcelona, España. Electronic address: [email protected].
² Servei de Cirurgia Ortopèdica i Traumatologia, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Barcelona, España; Universitat Autònoma de Barcelona (UAB), Barcelona, España.
³ Unidad de Rodilla, Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic, Universitat de Barcelona, Barcelona, España.
⁴ Departamento de Microscopía Electrónica, Centres Científics i Tecnològics de la UB (CCiTUB), Barcelona, España.
⁵ Unidad de Análisis Elemental, Centres Científics i Tecnològics de la Universitat de Barcelona (CCiTUB), Barcelona, España.
⁶ Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Departamento de Estadística, Hospital Clínic, Universitat de Barcelona, Barcelona, España.

PMID: 29454601
DOI: 10.1016/j.recot.2017.11.004

Abstract

Aim: To compare two different types of inserts: Ultra-high molecular weight polyethylene (UHMWPE) and cross-linked polyethylene with a quantitative and qualitative study of polyethylene wear particles in synovial fluid 3 years after total knee arthroplasty.

Material and methods: A prospective, randomized, controlled cohort study with blinded evaluation was carried out on 25 patients undergoing staged bilateral total knee replacement, 6 months apart. Knee arthrocentesis was performed on 12 patients 3 years after surgery, and the polyethylene particles were analyzed.

Results: No significant differences were found in the number of particles generated by the two different types of inserts at 3 years from total knee arthroplasty (3,000×: x¯ cross-linked=849.7; x¯ UHMWPE=796.9; P=.63; 20,000×: x¯ cross-linked=66.3; x¯ UHMWPE=73.1; P=.76). Likewise, no differences in the probability of finding elongated (χ²=0.19; P=.66) or rounded (χ²=1.44; P=.23) particles in both types of inserts were observed. However, the probability of finding fibrillar particles is 3.08 times greater in UHMWPE.

Conclusions: Cross-linked polyethylene does not significantly reduce the generation of polyethylene particles in patients with total knee arthroplasty, 3 years after the surgical procedure.

Keywords: Artroplastia total de rodilla; Líquido sinovial; Partículas de polietileno; Polyethylene particles; Synovial fluid; Total knee arthroplasty.

Publication types

Comparative Study
Randomized Controlled Trial

MeSH terms

Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee / instrumentation*
Female
Follow-Up Studies
Humans
Knee Prosthesis*
Male
Outcome Assessment, Health Care
Polyethylene / analysis
Polyethylene / chemistry*
Polyethylenes / analysis
Polyethylenes / chemistry*
Prospective Studies
Prosthesis Failure*
Single-Blind Method
Synovial Fluid / chemistry*

Substances

Polyethylenes
ultra-high molecular weight polyethylene
Polyethylene