Does Achieving High Flexion Increase Polyethylene Damage in Posterior-Stabilized Knees? A Retrieval Study

Increased range of motion to higher degrees of flexion following total knee arthroplasty has been postulated to increase implant damage and revision rates, even in designs modified to accommodate high flexion.

We examined posterior-stabilized and high-flexion retrieved tibial inserts to look for differences in polyethylene surface damage with light microscopy and 3D deviation with laser scanning between inserts from patients who achieved a high degree of flexion (≥120° postoperatively) and inserts from patients who did not reach a high degree of flexion.

No differences were found in damage scores on the articular and backside surfaces, except for abrasion in the posterior articular regions, or in 3D deviations between patients who reached a high degree of flexion and patients who did not. These results were independent of the reason for revision.

In our series, reaching a high degree of flexion did not influence surface damage or 3D deviation of the polyethylene inserts.