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The influence of kinematic conditions and design on the wear of patella-femoral replacements

The success rate of patella-femoral arthroplasty varies between 44% and 90% in 17 years of follow-up. Several studies have been performed previously for assessing the surface wear in the patella-femoral joint. However, they have not included all six degrees of freedom. The aim of this study was to d...

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Detalles Bibliográficos
Autores principales: Maiti, Raman, Fisher, John, Rowley, Liam, Jennings, Louise M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4361355/
https://www.ncbi.nlm.nih.gov/pubmed/24477888
http://dx.doi.org/10.1177/0954411913518910
Descripción
Sumario:The success rate of patella-femoral arthroplasty varies between 44% and 90% in 17 years of follow-up. Several studies have been performed previously for assessing the surface wear in the patella-femoral joint. However, they have not included all six degrees of freedom. The aim of this study was to develop a six-axis patella-femoral joint simulator to assess the wear rate for two patellae designs (round and oval dome) at different kinematic conditions. An increase in patellar rotation from 1° to 4° led to a significantly (p<0.049) increased wear rate of round dome from 8.6 mm(3)/million cycles to 12.3 mm(3)/million cycles. The wear rate for oval dome increased from 6.3 mm(3)/million cycles to 14.5 mm(3)/million cycles. However, the increase was nonsignificant (p>0.08). The increase in wear rate was likely due to the higher cross shear. A decrease in patellar medial lateral displacement from passive to constrained resulted in a nonsignificant reduction in wear (p>0.06). There was no significant difference in wear rate between the two patellae designs (p>0.28). The volumetric wear under all conditions was positively correlated with the level of passive patellar tilt (rho>0.8). This is the first report of preclinical wear simulation of patella-femoral joint in a six-axis simulator under different kinematic conditions.