Are there serious problems with knee replacement? The past 5 years, the concept of nasty wear particles in knee and hip replacement devices has come to the forefront. The worse offenders seem to be metal on metal devices, the ones commonly used for “minimally invasive” replacement or “resurfacing” of the joint. To get away from that and some of the problems seen with traditional plastic joints, device manufacturers began using cross linked polyetheylene. Now a new study shows that this new material may be a bigger problem than what it replaced.

The new study authors injected both polyethylene and it’s longer lasting cross linked cousin into the knees of an animal model. They then measured markers of inflammation and cartilage breakdown. The cross linked polyethylene caused the knee tissues to produce a much nastier stew of cartilage inflammation and breakdown chemicals.

The upshot? So much for cross-linked polyethylene! These findings are pretty disturbing as I’ve talked to many patients who believe that this type of plastic knee is the one that will keep them out of trouble. So is there a perfect material with which to craft a knee device? Maybe, but not one that I can see at this point.

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