THE EFFECTS OF TROCHLEAR DESIGN ON SURFACE DAMAGE AND WEAR IN RETRIEVED TOTAL KNEE IMPLANTS USING PROFILOMETRY
Notice bibliographique
Résumé
Introduction Complications related to the patellofemoral joint continue to be a substantial source of patient morbidity, causing anterior knee pain, instability, and dysfunction following total knee arthroplasty. One of the principle factors affecting patellofemoral outcomes may be trochlear design. The optimal design is currently unknown. The purpose of the present study was to study patellofemoral joint contact by analysing areas of wear in retrieved femoral components of three modern designs. Materials and Methods Eighteen retrieved femoral components featuring three different designs (constant radius of rotation, multiple radii of rotation, and multiple radii of rotation with built-in external rotation design) were matched on the basis of time-in-vivo, age, BMI and gender. All implants were cobalt chrome, posterior stabilized, cemented components with fixed bearing design with a resurfaced patella. Trochlear wear and surface damage were assessed using visual inspection, low-magnification light microscopy, and light profilometry. Results Six implants from each group were successfully matched and were used for the topographical analysis. The femoral components were closely matched on the basis of time-in-vivo (TIV) (2.4 years±1.2), age (71.6 years±11.3), and BMI (33.0 kg/m2±7.0). There were 9 males and 9 females in the sample. Infection was the most common reason for revision (n=14) followed by instability (n=3) and loosening (n=1). There were no significant differences in TIV, age, and BMI between the groups (p=0.366, p=0.829, and p=0.586, respectively). When compared with unused, reference components, both the retrieved constant radius implants (p 0.05). Visual inspection of the femoral components showed evidence of damage in all implant types. Modes of damage included scratches, striation, pitting, and delamination. No significant differences between the groups were found with respect to overall damage and wear on visual inspection (p=0.480). However, light profilometry analysis showed significantly increased roughness of multiple radii components compared to constant radius or multiple radii components with built-in external rotation (p<0.05). This was particularly significant in the proximal middle (p=0.045) and medial zones of the trochlea (p=0.017). Conclusions All retrieved femoral components show evidence of damage in the trochlear area. While retrieved constant radius and multiple radii components showed increased wear compared to new components, retrieved components with multiple radii and built-in external rotation did not differ significantly from their new state. Retrieved multiple radii components appeared to have increased roughness compared with constant radius or multiple radii with built-in external rotation, particularly in the proximal zones of the trochlea. The long term effects of increased trochlear roughness requires further investigation and correlation with clinical outcomes. As the volume and patient demands for total knee arthroplasty increase, a greater understanding of the effect of trochlear design on clinical outcomes is warranted.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».