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Polyethylene wear remains one of the major contributors of failure in Total Knee Arthroplasty [1,2]. It affects either the upper articulating with the femoral component surface of the insert, or the backside surface articulating with the tibial component. Although upper surface wear is predominant [3-5], backside wear has also been responsible for accumulation of wear debris in the synovial fluid [6,7]. Polyethylene wear particles in turn trigger an inflammatory granulomatous response with accumulation of macrophages and the release by them of cytokines. The result is osteolysis and aseptic loosening of the implants [8,9]. Recent studies have not shown any difference in the concentration of wear particles in the synovial fluid in fixed or mobile inserts [10]. However fixed bearing is linked to increased backside wear when the articulating upper surface is more conforming, compared to flatter contact surface [11].

orthopedics and rheumatology

Wear Evaluation Following Clinical use of Retrieved Polyethylene Mobile Inserts in Rotaglide Total Knee Replacement with a Combined Qualitative and Quantitative Topographic Method