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Bone Joint Res

Title:		The influence of a calcium sulphate bone void filler on the third-body damage and polyethylene wear of total knee arthroplasty
Author(s):		Cowie RM; Aiken SS; Cooper JJ; Jennings LM;
Address:		"Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK. Biocomposites Ltd, Keele, UK"
Journal Title:		Bone Joint Res
Year:		2019
Volume:		20190302
Issue:		2
Page Number:		65 - 72
DOI:		10.1302/2046-3758.82.BJR-2018-0146.R1
ISSN/ISBN:		2046-3758 (Print) 2046-3758 (Electronic) 2046-3758 (Linking)
Abstract:		"OBJECTIVES: Bone void fillers are increasingly being used for dead space management in arthroplasty revision surgery. The aim of this study was to investigate the influence of calcium sulphate bone void filler (CS-BVF) on the damage and wear of total knee arthroplasty using experimental wear simulation. METHODS: A total of 18 fixed-bearing U2 total knee arthroplasty system implants (United Orthopedic Corp., Hsinchu, Taiwan) were used. Implants challenged with CS-BVF were compared with new implants (negative controls) and those intentionally scratched with a diamond stylus (positive controls) representative of severe surface damage (n = 6 for each experimental group). Three million cycles (MC) of experimental simulation were carried out to simulate a walking gait cycle. Wear of the ultra-high-molecular-weight polyethylene (UHMWPE) tibial inserts was measured gravimetrically, and damage to articulating surfaces was assessed using profilometry. RESULTS: There was no significant difference (p > 0.05) between the wear rate of implants challenged with CS-BVF (3.3 mm(3)/MC (95% confidence interval (CI) 1.8 to 4.8)) and the wear rate of those not challenged (2.8 mm(3)/MC (95% CI 1.3 to 4.3)). However, scratching the cobalt-chrome (CoCr) significantly (p < 0.001) increased the wear rate (20.6 mm(3)/MC (95% CI 15.5 to 25.7)). The mean surface roughness of implants challenged with CS-BVF was equivalent to negative controls both after damage simulation (p = 0.98) and at the conclusion of the study (p = 0.28). CONCLUSION: When used close to articulating surfaces, a low-hardness, high-purity CS-BVF had no influence on wear. When trapped between the articulating surfaces of a total knee arthroplasty, CS-BVF did not scratch the surface of CoCr femoral components, nor did it increase the wear of UHMWPE tibial inserts compared with undamaged negative controls.Cite this article: R. M. Cowie, S. S. Aiken, J. J. Cooper, L. M. Jennings. The influence of a calcium sulphate bone void filler on the third-body damage and polyethylene wear of total knee arthroplasty. Bone Joint Res 2019;8:65-72. DOI: 10.1302/2046-3758.82.BJR-2018-0146.R1"
Keywords:		Biotribology Bone void filler Calcium sulphate Knee arthroplasty Ultra-high-molecular-weight polyethylene (UHMWPE);
Notes:		"PubMed-not-MEDLINECowie, R M Aiken, S S Cooper, J J Jennings, L M eng Wellcome Trust/United Kingdom England 2019/03/28 Bone Joint Res. 2019 Mar 2; 8(2):65-72. doi: 10.1302/2046-3758.82.BJR-2018-0146.R1. eCollection 2019 Feb"