Wear of mobile bearing knees: Is it necessarily less?

Hani Haider, Christian Kaddick

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Some well-known mobile bearing designs have had truly excellent long-term clinical results. Their lower constraint and ability for some self-alignment might have helped reduce the shear forces and torques transmitted to the prosthesis-bone interface, thereby lowering the risk of loosening. However, the most commonly assumed benefit of mobile bearings is the reduction in wear due to less contact stress and reduced cross shear. In a rotating platform, wear can be reduced because the rolling/sliding motion is separated from the transverse rotational motion, which reduces cross-shear. Although it has not been categorically proven clinically, such lower wear expectations with mobile bearings might have influenced the thinking of some total knee replacement (TKR) designers and test engineers. This paper amalgamates in vitro TKR wear results from two separate laboratories (in Nebraska and Germany) to present the largest data set ever published on wear, across the widest variety of fixed and mobile bearing TKR designs. Many hundreds of TKR samples were tested with largely similar methodologies using the ISO 14243-1 force-control method. These tests covered 133 different fixed and mobile bearing designs and materials, in total (bicondylar) and unicompartmental forms, and of a wide range of sizes. Clear differences in wear resulted with known superior bearing materials. This illustrates how sensitive and capable of discriminating between low and high wearing implants the force-control wear testing methodology is. However, between both labs, and across all tests, no statistically significant differences were found in wear overall between fixed and mobile bearings. Therefore, the wear of mobile bearing knees is not necessarily less than that of fixed bearings. In both, it depends on the detailed design and materials of the TKR. Testing appears to be necessary with all implant designs, regardless of the history of clinically successful predicates of seemingly similar generic design.

Original languageEnglish (US)
Title of host publicationMobile Bearing Total Knee Replacement Devices
PublisherASTM International
Pages218-231
Number of pages14
ISBN (Print)9780803175174
DOIs
StatePublished - 2012
EventASTM Symposium on Mobile Bearing Total Knee Replacement Devices - St. Louis, MO, United States
Duration: May 18 2010May 18 2010

Publication series

NameASTM Special Technical Publication
Volume1531 STP
ISSN (Print)0066-0558

Conference

ConferenceASTM Symposium on Mobile Bearing Total Knee Replacement Devices
CountryUnited States
CitySt. Louis, MO
Period5/18/105/18/10

Keywords

  • Fixed bearing
  • In vitro testing
  • Knee simulator
  • Mobile bearing
  • Rotating platform
  • TKR
  • Total knee replacement
  • Wear

ASJC Scopus subject areas

  • Materials Science(all)

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  • Cite this

    Haider, H., & Kaddick, C. (2012). Wear of mobile bearing knees: Is it necessarily less? In Mobile Bearing Total Knee Replacement Devices (pp. 218-231). (ASTM Special Technical Publication; Vol. 1531 STP). ASTM International. https://doi.org/10.1520/JAI104453