Latest Lessons Learned from Retrieval Analyses from UHMWPE and Alternative Bearing Total Disc Replacements

Reference:
Kurtz SM, Toth J, Siskey R, Cicarelli L, MacDonald D, Isaza J, Lanman T, Punt I, Steinbeck M, Goffin J, and van Oiij A. The Latest Lessons Learned from Retrieval Analyses of Ultra-High Molecular Weight Polyethylene, Metal-on-Metal, and Alternative Bearing Total Disc Replacements. Seminars in Spine Surgery, In press, 2012
Keywords:
total disc arthroplasty, total disc replacement, TDR, ultra-high molecular weight polyethylene, UHMWPE, wear, oxidation, retrieval analysis, explant analysis, stainless steel, polycarbonate urethane, PCU, polyurethane, cobalt chrome, CoCr, metal-on-metal, adverse local tissue reactions
Permissions:
This preprint manuscript is made available on uhmwpe.org with permission of Elsevier.

Abstract

Knowledge regarding the in vivo performance and periposthetic tissue response of cervical and lumbar total disc replacements (TDRs) continues to expand. This review addresses the following four main questions: 1) What are the latest lessons learned from polyethylene in large joints and how are they relevant to current TDRs? 2) What are the latest lessons learned regarding adverse local tissue reactions from metal-on-metal, CoCr bearings in large joints and how are they relevant to current TDRs? 3) What advancements have been made in understanding the in vivo performance of alternative biomaterials, such as stainless steel and polycarbonate urethane, for TDRs in the past five years? 4) How has retrieval analysis of all these various artificial disc bearing technologies advanced the state of the art in preclinical testing of TDRs? The study of explanted artificial discs and their associated tissues can help inform bearing selection as well as the design of future generations of disc arthroplasty. Analyzing retrieved artificial discs is also essential for validating preclinical test methods.

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