Is Wear Still a Concern in TKA with Contemporary Conventional and Highly Cross-Linked Polyethylene Tibial Liners in the Long Term?

Description

This presentation, led by Devin Asher, a third-year medical student from Rush University, focuses on the issue of polyethylene wear in total knee arthroplasty (TKA), highlighting its historical context and current relevance. Devin begins by acknowledging that previously, polyethylene wear was a significant factor contributing to failures in knee replacements, but recent data indicates that it now affects less than 2% to 4% of cases.



Through analysis of surgically retrieved liners, Devin outlines the main reasons for failure in TKA, which include instability, polyethylene wear, and aseptic loosening, with particular attention to delamination and subsurface cracking of the polyethylene materials. The study involves a robust sample of 688 liners with specific criteria, focusing on those in situ for over six and a half years, narrowing down to 107 tibial liners that conformed to the research requirements.



The findings suggest that conventional polyethylene wears significantly more than contemporary highly cross-linked polyethylene, with wear rates being 3.5 to 4.5 times greater on the medial and lateral sides respectively. This emphasizes the importance of material choice in prosthetic longevity and the necessity of continued research into these wear patterns. The conclusion drawn from the data strongly suggests that polyethylene wear remains a critical factor in the failure of TKA, with a conservative estimate indicating that about 30% of failures are linked to this issue after the specified time period.

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