Analysis of Wear Particle in Association with Aseptic Loosening in Cementless Total Knee Arthroplasty

ABSTRACT

INTRODUCTION: Although most stable total knee arthroplasties remain so for many years, recently asep-tic loosening of prosthesis due to osteolysis which are induced by polyethylene wear is one of important causes in TKA failure. The authours experienced two cases of TKA revision due to aseptic loosening, and analysed wear particles in association with aseptic loosening. MATERIALS AND METHODS: From Oct 1988 to July 1999, two cases among 400 TKA underwent revision TKA due to aseptic loosening. The periprosthetic interface membrane tissues were collected for analysis of wear particle. After enzymatic digestion, EDS and FT-IR employed for chemical and physical charac-teristics and SEM employed for size and morphology of particle. RESULTS: Radiolucent line were seen around tibial component and aseptic loosening were observed also. At revision operations, hypertrophy of synovium and interface membrane between prosthesis & host bone were confirmed. Pathology showed synovial hypertrophy and giant cell which impressed chronic inflammation due to foreign body. The isolated particles were mainly polyethylene debris. And the size of the particle was variable. Some were identified grossly, several mm, others were several micrometer. Also, submi-cron particles were seen. CONCLUSIONS: If aseptic loosening was developed in TKA, polyethylene wear particle should be consid-ered as a cause of loosening. The wear particles were variable in sized and more bigger than that in previ-ous reports of THA.