Wear characterization and contact surfaces analysis of menisci and femoral retrieved components in bi-condylar knee prostheses.

Saverio Affatato, Silvia Ruzzi, Marko Milosevic, Alessandro Ruggiero

Journal of the mechanical behavior of biomedical materials 2020 Oct

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Although total knee arthroplasty is a well-practiced surgical procedure, material properties and surface topography can contribute to the wear mechanisms and the implant failure. It has been advised that an increased femoral component's surface roughness of total knee prostheses may be a contributing factor to accelerated wear of the polyethylene menisci and eventually prosthesis failure. The aim of this study is to investigate the wear phenomena occurring on medial and lateral compartments of retrieved total knee arthroplasty in order to correlate the surface roughness vs. BMI, age at revision, and time in situ. Qualitative visual analyses were performed on all the retrieved knee components to assess the damage due to the wear phenomena. Quantitative analysis includes surface characterization performed using optical apparatus to describe surface roughness and morphology on the retrieved femoral, tibial and polyethylene component. The Mann-Whitney statistical test was performed to correlate the medial vs. lateral condyle surface roughness of all explants with BMI, age at revision, and time in situ. Visual and topographical analysis showed damage along the entire zone of the sliding contact area. A statistical difference between medial and lateral condyle roughness was found on four prosthesis. No statistical significance was found between surface roughness measurements and patient BMI, age at revision, and time in situ. On the femoral components various scratches were observed in the anterior/posterior (AP) direction of all the fixed femoral components. A statistically significant difference between medial and lateral condyle was found on two mobile knee design (p = 0.03) and on two fixed design (p = 0.01). The results were discussed in the framework of the usual TKR loading conditions during the gait, and of knowledge on the bio-tribological behavior of the prosthetic joint. The visual and topographical analysis showed consistent damage patterns with respect to the main movements to which the prosthetic components are subjected and no statistical significance was found between surface roughness measurements and patient BMI, age at revision, and time in situ. Copyright © 2020. Published by Elsevier Ltd.

Citation

Saverio Affatato, Silvia Ruzzi, Marko Milosevic, Alessandro Ruggiero. Wear characterization and contact surfaces analysis of menisci and femoral retrieved components in bi-condylar knee prostheses. Journal of the mechanical behavior of biomedical materials. 2020 Oct;110:103959