Our multi-disciplinary team of surgeons and engineers will present the mechanisms of

failure of knee replacements. We will correlate clinical and imaging data with retrieval

analyses in order to identify risk factors

Bills, Paul J.

Cerquiglini, Arianna

Hart, A. J.

Henckel, Johann

Hirschmann, A

Holland, Matthew

Hothi, Harry

Racasan, Radu

Rotigliano, Niccolo

Skinner, John

University of Huddersfield Repository

University of Huddersfield RepositoryCerquiglini, Arianna, Henckel, Johann, Hothi, Harry, Rotigliano, Niccolo, Holland, Matthew, Bills, Paul J., Racasan, Radu, Skinner, John, Hirschmann, A and Hart, A. J.Understanding Why Knee Implants FailOriginal CitationCerquiglini, Arianna, Henckel, Johann, Hothi, Harry, Rotigliano, Niccolo, Holland, Matthew, Bills, Paul J., Racasan, Radu, Skinner, John, Hirschmann, A and Hart, A. J. (2017) Understanding Why Knee Implants Fail. In: American Academy of Orthopaedic Surgeons Annual Meeting, March 14­18 2017, San Diego, CA, USA. (Unpublished) This version is available at http://eprints.hud.ac.uk/31701/The University Repository is a digital collection of the research output of theUniversity, available on Open Access. Copyright and Moral Rights for the itemson this site are retained by the individual author and/or other copyright owners.Users may access full items free of charge; copies of full text items generallycan be reproduced, displayed or performed and given to third parties in anyformat or medium for personal research or study, educational or not­for­profitpurposes without prior permission or charge, provided:• The authors, title and full bibliographic details is credited in any copy;• A hyperlink and/or URL is included for the original metadata page; and• The content is not changed in any way.For more information, including our policy and submission procedure, pleasecontact the Repository Team at: E.mailbox@hud.ac.uk.http://eprints.hud.ac.uk/Understanding Why Knee Implants Fail Scientific Exhibit AAOS 2017 Abstract  Cerquiglini, Henckel, Hothi, Rotigliano, Holland, Bills, Racasan, Skinner, Hirschmann, Hart    Summary  Our  multi-disciplinary team of  surgeons  and  engineers will  present the  mechanisms of failure of knee replacements. We will correlate clinical and imaging data with retrieval analyses in order to identify risk factors.    Introduction  Over 63,335 revisions of total knee arthroplasty (TKA) were performed in the United States in 2015 and this number is projected to grow by 601% between 2005 and 2030 at a cost of more than $2 billion annually.     In this exhibit we will help surgeons understand which surgical, implant and patient factors they should consider in their clinical management. We will present our metrology methods developed using state-of-the-art technology and demonstrate how combining these with high quality imaging of the implant, in situ and when explanted, can help explain failure mechanisms    Methods  Over the past two years, our retrieval centre has collected a large number of retrieved knee components together with detailed clinical data and pre-revision 3D imaging data for each patient. An innovative diagnostic algorithm, based on SPECT/CT imaging techniques, allows us  to  identify  accurately  both  implant  positioning  (axial  rotation,  varus-valgus  and extension-flexion angles) and peri-prosthetic bone metabolic activity.     All components are analysed in order to identify the: (1) wear pattern and location of both the articular and backside surfaces of polyethylene inserts, using macroscopic and microscopic techniques and combining Computed Tomography (CT) imaging of retrievals with Coordinate Measure Machine (CMM) metrology methods; (2) wear pattern of contact surfaces of both the femoral and tibial components, using profilometry and high resolution microscopy; (3) oxidation index of all the plastic inserts using Fourier Transform Infrared spectroscopy (FTIR); (4) presence of corrosion in all the metallic components, using scanning electron microscopy (SEM) and Energy-dispersive X-ray spectroscopy (EDX).             Results Our forensic analysis has enabled us to: (1) identify risk factors for failure of knee implants, (2) provide recommendations and guidelines for surgeons on who, when and how to revise painful knee implants, and (3) to suggest design modifications on current designs based on their present limitations    Conclusions Failure  of  knee  replacements can  be  multifactorial  influenced  by  surgical,  implant  and patient (SIP) factors. We will show the value of the developing and combing state-of-the-art clinical and engineering tools to explain failure mechanisms.                  

Understanding Why Knee Implants Fail

Understanding Why Knee Implants Fail

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