The use of highly cross-linked polyethylene in total knee arthroplasty.

Published

Journal Article (Review)

Polyethylene wear, with resultant particle-induced osteolysis, is a cause of late failure of total knee arthroplasty. The causes of both wear and osteolysis are multifactorial; still, improvements in the polyethylene liner have been investigated. Available highly cross-linked polyethylene tibial liners and patellar prostheses differ greatly in the amount and method of irradiation, thermal treatments, and sterilization techniques they undergo. Several varieties of highly cross-linked polyethylene reduce the gravimetric and volumetric wear of tibial liners in knee simulator studies. However, reduced fracture toughness and the generation of smaller and possibly more reactive particles also have been reported with some varieties of polyethylene. Clinical studies of the use of highly cross-linked polyethylene in total knee arthroplasty are limited. Two nonrandomized trials of highly cross-linked polyethylene in total knee arthroplasty have reported a nonsignificant decrease in radiolucent lines at 2 and 5 years, respectively. The risks of using highly cross-linked polyethylene include fracture of the liner or of a posterior-stabilized tibial post, liner dislodgement or locking mechanism disruption, and possibly more osteolysis. Highly cross-linked polyethylene tibial liners may be considered for younger, more active patients. However, until additional clinical results are available, a cautious approach is warranted to the widespread use of highly cross-linked polyethylene in total knee arthroplasty.

Full Text

Duke Authors

Cited Authors

  • Lachiewicz, PF; Geyer, MR

Published Date

  • March 2011

Published In

Volume / Issue

  • 19 / 3

Start / End Page

  • 143 - 151

PubMed ID

  • 21368095

Pubmed Central ID

  • 21368095

International Standard Serial Number (ISSN)

  • 1067-151X

Digital Object Identifier (DOI)

  • 10.5435/00124635-201103000-00003

Language

  • eng

Conference Location

  • United States