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. 2018 Feb;232(2):127-134.
doi: 10.1177/0954411917746433. Epub 2017 Dec 17.

Influence of conformity on the wear of total knee replacement: An experimental study

Claire L Brockett  1 , Silvia Carbone  1 , John Fisher  1 , Louise M Jennings  1
Affiliations

Influence of conformity on the wear of total knee replacement: An experimental study

Claire L Brockett et al. Proc Inst Mech Eng H. 2018 Feb.

Abstract

Wear of total knee replacement continues to be a significant factor influencing the clinical longevity of implants. Historically, failure due to delamination and fatigue directed design towards more conforming inserts to reduce contact stress. As new generations of more oxidatively stable polyethylene have been developed, more flexibility in bearing design has been introduced. The aim of this study was to investigate the effect of insert conformity on the wear performance of a fixed bearing total knee replacement through experimental simulation. Two geometries of insert were studied under standard gait conditions. There was a significant reduction in wear with reducing implant conformity. This study has demonstrated that bearing conformity has a significant impact on the wear performance of a fixed bearing total knee replacement, providing opportunities to improve clinical performance through enhanced material and design selection.

Keywords: Total knee replacement; conformity; polyethylene; wear.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: J.F. is an NIHR Senior Investigator.

Figures

Figure 1.
Figure 1.
Input conditions for wear simulation.
Figure 2.
Figure 2.
Cumulative mean wear rates for insert geometries (±95% confidence limits).
Figure 3.
Figure 3.
Mean wear rates for insert geometries (±95% confidence limits).
Figure 4.
Figure 4.
Examples of final wear scars for each design: (a) flat insert and (b) lipped insert.
Figure 5.
Figure 5.
Mean wear rates for conventional and moderately cross-linked polyethylene for three different insert designs (source citation indicated).
See this image and copyright information in PMC

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