Elsevier

The Journal of Arthroplasty

Volume 14, Issue 8, December 1999, Pages 940-944
The Journal of Arthroplasty

Original article
Failure of the all-polyethylene patellar component after total knee arthroplasty

https://doi.org/10.1016/S0883-5403(99)90007-4Get rights and content

Abstract

From 1991 to 1996, 953 cases of porous-coated anatomic modular knee prostheses with all-polyethylene patellar components were implanted. Among them, 4 cases had breakage of the patellar component at the peg-button interfaces. One had loosening of the patellar component by cutting out the patellar bony bed. Heavy body weight, weakness of the pegs of the all-polyethylene patellar component, and osteonecrosis of the patella were conceived as the causes of failure.

References (18)

  • G Scuderi et al.

    The relationship of lateral releases to patella viability in total knee arthroplasty

    J Arthroplasty

    (1987)
  • AF Lynch et al.

    Extensor mechanism complications following total knee arthroplasty

    J Arthroplasty

    (1987)
  • ML Clayton et al.

    Patellar complications after total condylar arthroplasty

    Clin Orthop

    (1982)
  • DL Bartel et al.

    Performance of the tibial component in the total knee replacement

    J Bone Joint Surg Am

    (1982)
  • AV Lombardi et al.

    Fracture/dissociation of the polyethylene in metal-backed patellar components in total knee arthroplasty

    J Bone Joint Surg Am

    (1988)
  • MS MacCollum et al.

    Complications of the PCA anatomic patella

    Orthopedics

    (1989)
  • M Roffman et al.

    Fracture of the resurfaced patella in total knee replacement

    Clin Orthop

    (1980)
  • AG Rosenberg et al.

    Patellar component failure in cementless total knee arthroplasty

    Clin Orthop

    (1988)
  • HU Cameson et al.

    The patella in total knee arthroplasty

    Clin Orthop

    (1982)
There are more references available in the full text version of this article.

Cited by (29)

  • Loading and kinematic profiles for patellofemoral durability testing

    2018, Journal of the Mechanical Behavior of Biomedical Materials
    Citation Excerpt :

    These results are not surprising since patellar maltracking has been previously indicated as one of the main complications of the resurfaced patella (Dennis, 1992). In addition to pain, patellar maltracking can cause larger contact pressures due to the limited contact area, which result in increased wear (Vanbiervliet et al., 2011), and greater shear contact forces, as indicated by the PCA results for Mode 2, which can lead to failure at the peg-button interface (Huang et al., 1999). Looking more closely at the percentage of deformed volume in the two profiles from Mode 2, it is possible to make distinctions between them.

  • Bearing surface failure in total knee arthroplasty

    2012, Seminars in Arthroplasty JSES
  • Bilateral Patellar Component Shear Failure of Highly Cross-Linked Polyethylene Components. Report of a Case and Laboratory Analysis of Failure Mechanisms.

    2012, Journal of Arthroplasty
    Citation Excerpt :

    No cement groove deformation was observed in the clinical retrievals. Patellar component shear failure with fracture of the fixation pegs, as reported here for a bilateral TKA patient with the Natural-Knee II System and Durasul HXPE design, is consistent with a small number of clinical fractures reported in the literature for all-polyethylene patellar components manufactured from conventional UHMWPE [1-5]. The shear fatigue test performed here successfully reproduced the clinical failure mode, with similar fracture patterns on the peg surfaces.

  • Patella Resurfacing in Total Knee Arthroplasty: The Sum of All Parts

    2008, Seminars in Arthroplasty JSES
    Citation Excerpt :

    In addition to the backing material, the design of the pegs in the all-polyethylene patellae (one-peg versus three-pegs) has been studied as a possible mode of failure. Fatigue fractures and shearing of the peg as a cause of patella failure has been reported.21,22 However, it remains to be seen which is a more durable design.

View all citing articles on Scopus

No benefits or funds were received in support of this study.

View full text