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Peg Shearing as a Method of Failure in Highly Cross-Linked Polyethylene Patellar Components Used in Patellofemoral Arthroplasty.

Journal articles  - Journal Article
Pierce, M; Leal, J; Mills, FB; Shah, J; Bolognesi, MP; Jiranek, WA
Published in: Arthroplast Today
August 2026

Highly cross-linked polyethylene (HXLPE) is commonly used in knee arthroplasty due to its improved wear resistance. However, increased crosslinking reduces the tensile strength and fatigue resistance of polyethylene, which may be detrimental in high shear environments such as a cemented patellar button. In patellofemoral arthroplasty (PFA), patellar components are exposed to substantial shear stresses, which may predispose polyethylene components to fatigue-related failure and peg shear. We report a case series of patellar component failures in PFA, including several HXLPE patellar buttons demonstrating peg fracture and loosening, as well as 1 ultra-high molecular weight polyethylene patellar button with a similar failure pattern. To our knowledge, these represent the first reported cases of HXLPE patellar component peg shear in PFA, a complication previously described only in the setting of total knee arthroplasty.

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Published In

Arthroplast Today

DOI

ISSN

2352-3441

Publication Date

August 2026

Volume

40

Start / End Page

102112

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pierce, M., Leal, J., Mills, F. B., Shah, J., Bolognesi, M. P., & Jiranek, W. A. (2026). Peg Shearing as a Method of Failure in Highly Cross-Linked Polyethylene Patellar Components Used in Patellofemoral Arthroplasty. Arthroplast Today, 40, 102112. https://doi.org/10.1016/j.artd.2026.102112
Pierce, Morgan, Justin Leal, Fredrick Baker Mills, Jason Shah, Michael P. Bolognesi, and William A. Jiranek. “Peg Shearing as a Method of Failure in Highly Cross-Linked Polyethylene Patellar Components Used in Patellofemoral Arthroplasty.” Arthroplast Today 40 (August 2026): 102112. https://doi.org/10.1016/j.artd.2026.102112.
Pierce M, Leal J, Mills FB, Shah J, Bolognesi MP, Jiranek WA. Peg Shearing as a Method of Failure in Highly Cross-Linked Polyethylene Patellar Components Used in Patellofemoral Arthroplasty. Arthroplast Today. 2026 Aug;40:102112.
Pierce, Morgan, et al. “Peg Shearing as a Method of Failure in Highly Cross-Linked Polyethylene Patellar Components Used in Patellofemoral Arthroplasty.” Arthroplast Today, vol. 40, Aug. 2026, p. 102112. Pubmed, doi:10.1016/j.artd.2026.102112.
Pierce M, Leal J, Mills FB, Shah J, Bolognesi MP, Jiranek WA. Peg Shearing as a Method of Failure in Highly Cross-Linked Polyethylene Patellar Components Used in Patellofemoral Arthroplasty. Arthroplast Today. 2026 Aug;40:102112.
Journal cover image

Published In

Arthroplast Today

DOI

ISSN

2352-3441

Publication Date

August 2026

Volume

40

Start / End Page

102112

Location

United States