Rodriguez-Merchan Emerito Carlos, Ribbans William J
Department of Orthopedic Surgery, Hospital Universitario La Paz-IdiPaz, Madrid 28046, Spain.
Faculty of Health, Education and Society, University of Northampton, Northampton, United Kingdom and The County Clinic, Northampton NN1 5DB, United Kingdom.
World J Orthop. 2025 Mar 18;16(3):102160. doi: 10.5312/wjo.v16.i3.102160.
Retrieval analysis in total knee arthroplasty (TKA) has been little studied in the literature. A narrative review of the literature to understand the current importance of retrieval analysis in TKA has been conducted. On August 27, 2024, a literature search was performed in PubMed using "TKA retrieval analysis" as keywords. A total of 160 articles were found, of which only 19 were analyzed because they were directly related to the subject of this article. Rotating-platform (mobile-bearing) TKA has no surface damage advantage over fixed-bearing TKA. TKAs with central locking mechanisms are more prone to debond from the cement mantle. No major wear of the polyethylene (PE) component in TKA using oxidized zirconium components occurs. Femoral components of cobalt-chromium roughen more than oxidized zirconium femoral components. The use of a polished tibial tray over an unpolished design is advised. At short-run assessment (15 months on average), antioxidant-stabilized highly crosslinked PE components are not clinically different in surface damage, density of crosslinking, or oxidation compared to standard remelted highly crosslinked PE components. A correlation between implant position and PE component surface damage has been reported. It shows the importance of optimizing component position to reduce PE component damage. Contemporary knee tumor megaendoprostheses show notable volumetric metal wear originated at the rotating hinge. Retrieval analysis in TKA renders relevant data on how different prosthetic designs described in the literature perform. Such information can help to improve future prosthetic designs to increase prosthetic survival.
全膝关节置换术（TKA）中的取出分析在文献中研究较少。本文进行了一项文献综述，以了解取出分析在TKA中的当前重要性。2024年8月27日，在PubMed上以“TKA取出分析”为关键词进行了文献检索。共找到160篇文章，其中仅19篇被分析，因为它们与本文主题直接相关。旋转平台（活动轴承）TKA在表面损伤方面并不比固定轴承TKA更具优势。具有中央锁定机制的TKA更容易从骨水泥套中脱粘。使用氧化锆部件的TKA中聚乙烯（PE）部件未出现严重磨损。钴铬合金股骨部件比氧化锆股骨部件磨损更严重。建议使用抛光的胫骨托而非未抛光的设计。在短期评估（平均15个月）中，抗氧化稳定的高度交联PE部件与标准重熔高度交联PE部件相比，在表面损伤、交联密度或氧化方面无临床差异。已有报道称植入物位置与PE部件表面损伤之间存在相关性。这表明优化部件位置以减少PE部件损伤的重要性。当代膝关节肿瘤大假体在旋转铰链处出现明显的体积性金属磨损。TKA中的取出分析提供了有关文献中描述的不同假体设计性能的相关数据。这些信息有助于改进未来的假体设计以提高假体生存率。
