Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Dec 1990
Cementless total joint arthroplasty prostheses with titanium-alloy articular surfaces. A human retrieval analysis.
Surgical implants of titanium alloy (Ti-6Al-4V) have been found to be susceptible to abrasive wear, resulting in the well-known phenomenon of metallosis. In the presence of the acrylic debris generated by loose joint arthroplasty prostheses, this abrasive wear is greatly increased. However, the bone loss seen in these cases has generally been presumed to be due to the osteolytic effects of particulate acrylic, not the alloy debris, which has generally been assumed to be biocompatible. ⋯ Visible burnishing was observed on every articular surface, with a linear relationship between wear and time implanted. By one year the surfaces were covered with a characteristic "scratch and gouge" pattern, similar on all sizes of femoral heads as well as the total knee prostheses. This study demonstrates that the combination of Ti-6Al-4V alloy and UHMWPE, when used as a bearing surface combination in total joint arthroplasty prostheses, results in excessive wear of both metal and polymer.(ABSTRACT TRUNCATED AT 400 WORDS)
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The prognosis for peroneal palsy after total knee arthroplasty (TKA) is poorly defined. Twenty-six postoperative peroneal palsies occurred after 8998 TKAs performed between 1972 and 1985. Eighteen patients had complete and eight had incomplete peroneal palsies. ⋯ Complete recovery was more likely in those palsies that were incomplete initially. Patients with palsies that were initially partial had significantly higher knee scores than those with complete palsies, and patients whose eventual recovery was complete had significantly higher knee scores than those with incomplete recovery. This new prognostic information should be useful for surgeons who encounter this unfortunate yet persistent complication of TKA.