Metrology to Quantify Wear and Creep of Polyethylene Tibial Knee Inserts

Assessment of damage on articular surfaces of ultrahigh molecular weight polyethylene tibial knee inserts primarily has been limited to qualitative methods, such as visual observation and classification of features such as pitting, delamination, and subsurface cracking. Semiquantitative methods also have been proposed to determine the linear penetration and volume of the scar that forms on articular surfaces of tibial knee inserts. The current authors report a new metrologic method that uses a coordinate measuring machine to quantify the dimensions of this scar. The articular surface of the insert is digitized with the coordinate measuring machine before and after regular intervals of testing on a knee simulator. The volume and linear penetration of the scar are calculated by mathematically taking the difference between the digitized surface maps of the worn and unworn articular surfaces. Three conventional polyethylene tibial knee inserts of a posterior cruciate-sparing design were subjected to five million cycles of normal gait on a displacement-driven knee wear simulator in bovine serum. A metrologic method was used to calculate creep and wear contributions to the scar formation on each tibial plateau. Weight loss of the inserts was determined gravimetrically with the appropriate correction for fluid absorption. The total average wear volume was 43 ± 9 and 41 ± 4 mm³ measured by the metrologic and gravimetric methods, respectively. The wear rate averaged 8.3 ± 0.9 and 8.5 ± 1.6 mm³ per million cycles measured by the metrologic and gravimetric methods, respectively. These comparisons reflected strong agreement between the metrologic and gravimetric methods.