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Stress shielding caused by the implant, leading to bone resorption
22%
140/640
Polyethylene wear debris from the tibiofemoral surface articulation
10%
61/640
Metal wear debris from the tibiofemoral surface articulation
3%
22/640
Cement debris from the cement-bone fixation surfaces
Polyethylene fretting wear debris from the backside of the insert
55%
352/640
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A number of studies have shown that in some designs of total knee implants, micromotion and fretting between the backside of the polyethylene insert and the tibial tray can generate significant amounts of wear debris, sufficient to cause substantial osteolysis. Stress shielding is not a likely cause in this case because there is no intramedullary stem. In general, articulation of metal against polyethylene generates insignificant amounts of metal wear debris.
2.8
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