Abstract
Purpose: To determine if Cobalt-Chrome (CoCr) femoral components of knee replacement components roughen significantly, and when significant roughening may start.
Methods:
Retrieval study:
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14 knee replacement components were retrieved after revision procedures. The average surface roughness (Ra) of the articulating regions of each condyle was measured by surface profilometry and compared to Ra of non-articulating regions, which acted as controls on each implant.
In vitro testing:
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Pin-on-plate testing of 6 paired CoCr pins and vacuum γ-irradiated UHMWPE discs was carried out under a force of 2.3kN at 1Hz to investigate how the articular Ra of CoCr pins varied with increasing number of cycles. Ra was measured at 0, 10, 100 and 1000 cycles using surface profilometry.
Results:
Retrieval analysis:
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Average medial femoral condyle Ra was significantly greater than control Ra (p=0.040). Average lateral femoral condyle Ra was not significantly greater than control Ra (p=0.158). Significantly higher average Ra was seen on the medial condyles when compared with the lateral condyles (p < 0.05). 8/14 retrieved femoral components had ≥1 significantly roughened condyle (p< 0.05).
In vitro testing:
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At 100 and 1000 cycles the Ra of the CoCr pins was significantly greater than Ra at 0 cycles (p< 0.05).
Conclusion: A large proportion of femoral components of knee replacement implants roughen significantly in vivo, a finding supported by our in vitro testing which indicates that roughening may begin very early on. This may have important implications for aseptic loosening of knee replacement components. However, the average Ra of those CoCr surfaces significantly (p< 0.05) roughened was within acceptable limits for orthopaedic implants (0.050μm).
Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
