Original ArticlesActivity level and wear in total knee arthroplasty: A study of autopsy retrieved specimens*,**
Section snippets
Materials and methods
The patient cohort studied consisted of 22 nonconsecutive patients with 28 polyethylene inserts that had undergone primary TKA. All the specimens were obtained from an ongoing autopsy retrieval program at the John Hopkins University and patients consented for the retrieval before their death. All patients had received a primary Porous Coated Anatomic (PCA) prosthesis and had died with a clinically successful TKA. All of the inserts were of the nonconforming flat-on-flat design and manufactured
Results
Preoperatively, 13 patients' knees were classified as Charnley A, 4 were B, and 11 were C. According to the UCLA activity scale preoperatively, 2 patients were wholly inactive, dependent on others, and could not leave their residence (group 1); 5 patients were mostly inactive or restricted to minimal activities of daily living (group 2); 17 patients sometimes or regularly participated in mild activities, such as walking, limited housework, and limited shopping (group 3); and 3 patients
Discussion
Numerous studies have been published on insert wear in total hip arthroplasty and TKA 7, 9, 17, 23. Acetabular polyethylene wear has been measured on autopsy retrieved components, and in vivo wear rates have been calculated 24, 25. These studies have associated increased wear with prosthesis design, material issues 9, 26, 32-mm head sizes 24, 25, titanium bearing surfaces, and polyethylene quality and thickness 9, 17, 27. Age and activity level have been reported to be important factors
Conclusions
1. Activity level correlated with deformation and creep patterns in polyethylene inserts in TKAs with this particular design.
2. Age and activity level showed little correlation.
References (31)
- et al.
Wear in retrieved condylar knee arthroplasties
J Arthroplasty
(1997) - et al.
Polyethylene debris-induced osteolysis and loosening in uncemented total hip arthroplasty: a cause of late failure
J Arthroplasty
(1992) - et al.
Physical status score and trends in anesthetic complications
J Clin Epidemiol
(1988) - et al.
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
J Chronic Dis
(1987) - et al.
Assessing activity in joint replacement patients
J Arthroplasty
(1998) - et al.
Progressive subluxation and polyethylene wear in total knee replacements with flat articular surfaces
Clin Orthop
(1994) - et al.
Polyethylene failure in New Jersey low contact stress total knee arthroplasty
J Biomed Mater Res
(1998) - et al.
Wear of congruent meniscal bearings in unicompartmental knee arthroplasty
J Bone Joint Surg Br
(1998) - et al.
Polyethylene wear in meniscal knee replacement: a one to nine-year retrieval analysis of the Oxford Knee
J Bone Joint Surg Br
(1992) - et al.
Polyethylene wear of metal-back tibial components in total and unicompartmental knee prostheses
J Bone Joint Surg Br
(1992)
Wear of polyethylene in total joint replacements: observations from retrieved PCA knee implants
Clin Orthop
Tibial high-density polyethylene wear in conforming tibiofemoral prostheses
J Bone Joint Surg Br
Radiographic evaluation of penetration by the femoral head into the polyethylene liner over time
J Bone Joint Surg Am
Pelvic lysis and polyethylene wear at 5-8 years in an uncemented total hip
Clin Orthop
Wear particulate species and bone loss in failed total joint arthroplasties
Clin Orthop
Cited by (108)
Comparison of Outcomes in High Versus Low Activity Level Patients After Total Joint Arthroplasty
2024, Journal of ArthroplastyObesity does not associate with 5-year surgical complications following anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty
2023, Journal of Shoulder and Elbow SurgeryA high physical activity level after total knee arthroplasty does not increase the risk of revision surgery during the first twelve years: A systematic review with meta-analysis and GRADE
2022, KneeCitation Excerpt :Jassim et al. [28] explored whether patients were able to return to athletic activity after TKA, with a secondary aim to evaluate implant survival. They found no increased risk of implant failure in active patients, based on a retrieval study [17] (not included in this review) and a case–control study by Jones et al. [24] (included in this review). The second systematic review focused on which host factors (e.g., sex, BMI and activity levels) affect aseptic loosening after TKA.
Does Activity Level After Primary Total Hip Arthroplasty Affect Aseptic Survival?
2021, Arthroplasty TodayAllowed Activities After Primary Total Knee Arthroplasty and Total Hip Arthroplasty
2020, Orthopedic Clinics of North America
- *
This work was supported by a generous grant from the Arthritis Surgery Research Foundation.
- **
Reprint requests: Carlos J. Lavernia, MD, 1321 NW 14th Street, Suite 203, Miami, FL 33125.