Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage

Abstract Background With the Persona® knee system a new polyethylene formulation incorporating vitamin-E which aims to reduce oxidation and maintain wear resistance was introduced. Although in-vitro studies have demonstrated positive effects of the vitamin-E antioxidants on UHMWPE, no retrieval stud...

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Autores principales:	Dominic T. Mathis, Joshua Schmidli, Michael T. Hirschmann, Felix Amsler, Johann Henckel, Harry Hothi, Alister Hart
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Total knee arthroplasty Polyethylene Retrieval analysis Polyethylene surface damage Surface roughness Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/0e76e0183a674a7ea25b18811bba236e
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spelling	oai:doaj.org-article:0e76e0183a674a7ea25b18811bba236e2021-12-05T12:18:28ZComparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage10.1186/s12891-021-04898-y1471-2474https://doaj.org/article/0e76e0183a674a7ea25b18811bba236e2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04898-yhttps://doaj.org/toc/1471-2474Abstract Background With the Persona® knee system a new polyethylene formulation incorporating vitamin-E which aims to reduce oxidation and maintain wear resistance was introduced. Although in-vitro studies have demonstrated positive effects of the vitamin-E antioxidants on UHMWPE, no retrieval study has looked at polyethylene damage of this system yet. It was the aim to investigate the in-vivo performance of this new design, by comparing it with its predecessor in retrieval analysis. Methods 15 NexGen® and 8 Persona® fixed-bearing implants from the same manufacturer (Zimmer Biomet) were retrieved from two knee revision centres. For retrieval analysis, a macroscopic analysis of polyethylene using a peer-reviewed damage grading method was used (Hood-score). The roughness of all articulating metal components was measured using a contact profilometer. The reason(s) for TKA revision were recorded. Statistical analyses (t-test) were performed to investigate differences between the two designs. Results The mean Hood score for Persona® inserts was 109.3 and for NexGen® 115.1 without significant differences between the two designs. Results from the profilometer revealed that Persona® and NexGen® femoral implants showed an identical mean surface roughness of 0.14 μm. The Persona® tibial tray showed a significantly smoother surface (0.06 μm) compared to the NexGen® (0.2 μm; p < 0.001). Both Hood score and surface roughness were influenced by the reasons for revision (p < 0.01). Conclusions The bonding of the antioxidant vitamin-E to the PE chain used in the novel Persona® knee system does not reduce in-vivo surface damage compared to highly crosslinked PE without supplemented vitamin-E used in its predecessor knee system NexGen®. However, the Persona® titanium alloy tibial tray showed a significantly smoother surface in comparison to the NexGen® titanium alloy tibial tray. This study provides first retrieval findings of a novel TKA design and may help to understand how the new Persona® anatomic knee system performs in vivo.Dominic T. MathisJoshua SchmidliMichael T. HirschmannFelix AmslerJohann HenckelHarry HothiAlister HartBMCarticleTotal knee arthroplastyPolyethyleneRetrieval analysisPolyethylene surface damageSurface roughnessDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Total knee arthroplasty Polyethylene Retrieval analysis Polyethylene surface damage Surface roughness Diseases of the musculoskeletal system RC925-935
spellingShingle	Total knee arthroplasty Polyethylene Retrieval analysis Polyethylene surface damage Surface roughness Diseases of the musculoskeletal system RC925-935 Dominic T. Mathis Joshua Schmidli Michael T. Hirschmann Felix Amsler Johann Henckel Harry Hothi Alister Hart Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage
description	Abstract Background With the Persona® knee system a new polyethylene formulation incorporating vitamin-E which aims to reduce oxidation and maintain wear resistance was introduced. Although in-vitro studies have demonstrated positive effects of the vitamin-E antioxidants on UHMWPE, no retrieval study has looked at polyethylene damage of this system yet. It was the aim to investigate the in-vivo performance of this new design, by comparing it with its predecessor in retrieval analysis. Methods 15 NexGen® and 8 Persona® fixed-bearing implants from the same manufacturer (Zimmer Biomet) were retrieved from two knee revision centres. For retrieval analysis, a macroscopic analysis of polyethylene using a peer-reviewed damage grading method was used (Hood-score). The roughness of all articulating metal components was measured using a contact profilometer. The reason(s) for TKA revision were recorded. Statistical analyses (t-test) were performed to investigate differences between the two designs. Results The mean Hood score for Persona® inserts was 109.3 and for NexGen® 115.1 without significant differences between the two designs. Results from the profilometer revealed that Persona® and NexGen® femoral implants showed an identical mean surface roughness of 0.14 μm. The Persona® tibial tray showed a significantly smoother surface (0.06 μm) compared to the NexGen® (0.2 μm; p < 0.001). Both Hood score and surface roughness were influenced by the reasons for revision (p < 0.01). Conclusions The bonding of the antioxidant vitamin-E to the PE chain used in the novel Persona® knee system does not reduce in-vivo surface damage compared to highly crosslinked PE without supplemented vitamin-E used in its predecessor knee system NexGen®. However, the Persona® titanium alloy tibial tray showed a significantly smoother surface in comparison to the NexGen® titanium alloy tibial tray. This study provides first retrieval findings of a novel TKA design and may help to understand how the new Persona® anatomic knee system performs in vivo.
format	article
author	Dominic T. Mathis Joshua Schmidli Michael T. Hirschmann Felix Amsler Johann Henckel Harry Hothi Alister Hart
author_facet	Dominic T. Mathis Joshua Schmidli Michael T. Hirschmann Felix Amsler Johann Henckel Harry Hothi Alister Hart
author_sort	Dominic T. Mathis
title	Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage
title_short	Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage
title_full	Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage
title_fullStr	Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage
title_full_unstemmed	Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage
title_sort	comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-e does not reduce in-vivo surface damage
publisher	BMC
publishDate	2021
url	https://doaj.org/article/0e76e0183a674a7ea25b18811bba236e
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Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage

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