Piliciauskaite, Ausrine;
(2022)
Retrieval Analysis of Contemporary Knee Implants.
Masters thesis (M.Phil), UCL (University College London).
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Abstract
Total knee arthroplasty (TKA) is a successful treatment for end-stage osteoarthritis. However, 20% of TKA patients remain unsatisfied due to poor knee function, defined as pain and functional difficulties assessed using disease-specific patient-centred pain outcome measures. The thesis aims to understand the multifactorial root cause of TKA implant failure. Aseptic loosening is one of the major complications that lead to knee implant replacement. The potential root cause of aseptic loosening is implant-cement-bone interface failure. The thesis is the first study that analysed a large sample group of 175 retrieved cemented TKA tibial tray components of 8 different designs. The surface depth and implant weight have been found to significantly (p<0.001) influence macroscopic bone cement adhesion to the tibial trays. Furthermore, the correlation between microscopic and macroscopic cement adhesion was investigated. The microscopic features were analysed using microscopic photogrammetry, profilometry, Fourier transform infrared spectroscopy, and scanning electron microscopy. Implants with a rougher surface (Ra > 0.60 μm) showed a significant difference (p<0.001) between the microscopic and macroscopic cement adhesion. The microscopic investigation informs about initial cement adhesion and implant micromotion in-vivo. Constrained posterior stabilised (PS) design implants constitute around 26% of all implants implanted in the UK per year. They use a post to limit the forward motion of a knee. In the previous studies, the post damage was visible in all retrieved implants. The thesis investigated the relationship between the post damage patterns, design features and implant positioning. Association between the insert post and the femoral box clearance, sharp apex of the post, non-congruent post-cam mechanism, implant mispositioning and the post damage was found. The implant design, bone cement and implant positioning factors that could contribute to contemporary TKA implant failure were investigated in this thesis. The results inform future implant development and help to prevent implant failure.
| Type: | Thesis (Masters) |
|---|---|
| Qualification: | M.Phil |
| Title: | Retrieval Analysis of Contemporary Knee Implants |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10152295 |
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