Differences in Trochlear Surface Damage and Wear Between Three Different Total Knee Arthroplasty Designs

Abstract

IntroductionTrochlear design plays a role in patellofemoral kinematics. Little is known regarding differences in the contact properties between modern designs. The purpose of the present study was to analyze patellofemoral joint contact by identifying areas of joint surface damage and wear in retrieved femoral components of 3 modern designs. MaterialsEighteen retrieved femoral components featuring 3 different modern designs (Triathlon, SIGMA, and GENESIS II) were matched based on time-in-vivo, age, gender, and body mass index. Trochlear wear and surface damage were assessed using visual inspection, light microscopy, and light profilometry. ResultsVisual inspection of the femoral components showed evidence of surface damage in all implant types. No significant differences between the groups were found with respect to surface damage and wear on visual inspection. Light profilometry of retrieved components showed that retrieved Triathlon (P = .002) and SIGMA (P = .009) components were significantly rougher than the corresponding reference components. The GENESIS II retrieved components were not substantially rougher than the reference components (P = .48). Light profilometry analysis showed significantly increased roughness of retrieved SIGMA components compared with Triathlon or GENESIS II components, particularly in the proximal trochlear groove and the medial trochlea. ConclusionAs the volume and patient demands for total knee arthroplasty increase, a greater understanding of the patellofemoral joint is warranted. Patellofemoral kinematics can have an effect on the surface characteristics of total knee arthroplasty components. Retrieved SIGMA components appeared to have increased roughness compared with Triathlon or GENESIS II components. The etiology and long-term effects of increased trochlear roughness require further investigation.