Article Figures & Data
Figures
- Fig. 1
Laveen wear test machine.
- Fig. 2
Schematic of the wear tests. Wear test I was conducted with 5 MC of coupled lateral bending (LB) and axial rotation (AR), followed by 10 MC of flexion-extension (FE). Wear test II was performed in the reverse order, with 10 MC of FE, followed by 5 MC of coupled motion.
- Fig. 3
Photomicrograph of inferior (trough) component after 0.5 and 5.0 MC of in vitro wear testing in coupled motion.
- Fig. 4
Mean volume loss (in cubic millimeters) as a function of the number of cycles for samples undergoing lateral bending and axial rotation followed by flexion-extension (n = 3 samples). The wear rate for lateral bending and axial rotation was 0.760 mm3/MC (R 2 = 0.95), and the wear rate for flexion-extension was 0.059 mm3/MC (R 2 = 0.96).
- Fig. 5
Mean volume loss (in cubic millimeters) as a function of the number of cycles for samples undergoing flexion-extension followed by lateral bending and axial rotation (n = 3 samples). The wear rate for flexionextension was 0.004 mm3/MC (R 2 = 0.64), and the wear rate for lateral bending and axial rotation was 0.720 mm3/MC (R 2 = 0.97).
- Fig. 6
Photomicrographs of PRESTIGE® I and II retrievals. The wear scar on the bearing surface has been highlighted in blue for each retrieval.
- Fig. 7
Photomicrographs of PRESTIGE® retrievals. The wear scar on the bearing surface has been highlighted in blue for each retrieval, when discernible.
- Fig. 8
Composite wear maps of the inferior and superior components, illustrating the variability in the size and extent of the wear scar for (A) in vitro wear-tested components (n = 3) at 15 MC after wear test I (Fig. 1) and (B) explanted components (n = 10).
- Fig. 9
(A) Photomicrographs and SEM micrographs of the superior (spherical) component at 15 MC after wear test I (Fig. 1). (B) Photomicrographs and SEM micrographs of an explanted, superior (spherical) component after 0.7 years in vivo.
- Fig. 10
Scanning electron microscopy of surface deposits on a retrieved screw head and screw hole: (A) screw head (20× magnification), (B) screw head (100× magnification), (C) screw hole (20× magnification), (D) screw hole (100× magnification).
- Fig. 11
Anterior impingement in a component retrieved after 2.3 years in vivo. (A) Photomicrograph of entire component. (B) Detail of impingement region.
Tables
- Table 1
Comparison of motion and loading profiles used and final consensus motions and loading published in ASTM F2423-05
Flexion-extension Lateral bending Axial rotation Axial load ASTM F2423-05 ±7.5° ±6.0° ±6.0° 100 N Profile I (5 MC) ±4.7° ±3.8° 49 N Profile II (10 MC) ±9.7° 148 N Implant Implant design Age at implantation (y) Gender Primary diagnosis Level Year of index surgery Year of removal surgery Implantation time (y) Revision reason Revision reason category PRESTIGE 1 PRESTIGE 25 F Disc herniation C6/C7 2003 2004 0.8 Pain in the neck, right shoulder, and right arm accompanied by decreased sensation in the right little finger; revised to anterior cervical fusion at C5 through C7; symptoms resolved Neck pain PRESTIGE 2 PRESTIGE 41 M Left C6/C7 disc herniation;
left C6 radiculopathyC6/C7 2003 2004 1.2 C6 radiculopathy; removal for adjacent-level fusion; revised to anterior cervical fusion; symptoms unresolved Radiculopathy PRESTIGE 3 PRESTIGE II 38 M Unknown C5/C6 2002 2003 1.8 Deep infection; revised to fusion with iliac crest bone; symptoms resolved Infection PRESTIGE 4 PRESTIGE I 31 F Unknown C5/C6 1998 1999 1.2 Unresolved neck pain; revised to fusion with iliac crest bone; symptoms unresolved Neck pain PRESTIGE 5 PRESTIGE I 42 M Unknown C6/C7 1998 2001 3.3 Disc removed to facilitate fusion at adjacent level (C5/C6); revised with Brantigan cage fusion and Codman plating from C5 through C7; symptoms resolved None PRESTIGE 6 PRESTIGE II 43 M Unknown C6/C7 2001 2001 0.3 Unresolved neck pain and posterior rigidity; improper device placement; revised to fusion with anterior cervical cage; outcome unknown Neck pain PRESTIGE 7 PRESTIGE 29 M HNP C6/C7 2004 2005 0.7 Unresolved neck pain and headache; revised to anterior fusion; symptoms unresolved Neck pain PRESTIGE 8 PRESTIGE 39 M Disc herniation C5/C6 2003 2005 2.3 Continued symptoms (neck and arm pain with radiculopathy); revised to anterior cervical fusion at C4 through C7; outcome unknown Neck pain and radiculopathy; continued symptoms PRESTIGE 9 PRESTIGE 35 M Cervical spondylosis C5/C6 2004 2006 2.2 Neck pain; sporting injury resulting in HNP at C6/C7; revised to anterior cervical fusion at C5 through C7; outcome unknown Neck pain PRESTIGE 10 PRESTIGE 32 M Disc degeneration C5/C6 2004 2009 4.1 Neck pain Neck pain Abbreviations: F, female; M, male; HNP, herniated nucleus pulposus.
Implant Inferior
damage scoreSuperior
damage scoreTotal
damage scoreScrew
frettingImpingement Superior wear scar
(mean ± SD) (µm)Inferior wear scar
(mean ± SD) (µm)Ra Wa Ra Wa PRESTIGE 1 Unknown Unknown Unknown Unknown Unknown NA NA NA NA PRESTIGE 2 2 2 4 Yes No 0.06 ± 0.01 0.02 ± 0.01 0.12 ± 0.04 0.05 ± 0.02 PRESTIGE 3 2 1 3 Yes Yes 0.12 ± 0.02 0.03 ± 0.01 0.09 ± 0.03 0.03 ± 0.01 PRESTIGE 4 2 2 4 Yes No 0.20 ± 0.18 0.06 ± 0.08 0.07 ± 0.03 0.01 ± 0.01 PRESTIGE 5 2 2 4 Yes Yes 0.11 ± 0.02 0.03 ± 0.01 0.13 ± 0.10 0.09 ± 0.08 PRESTIGE 6 2 2 4 Yes Yes 0.17 ± 0.04 0.06 ± 0.03 0.25 ± 0.11 0.08 ± 0.07 PRESTIGE 7 3 2 5 Yes No 0.05 ± 0.04 0.02 ± 0.02 0.04 ± 0.02 0.01 ± 0.00 PRESTIGE 8 1 1 2 Yes Yes 0.15 ± 0.07 0.08 ± 0.04 0.05 ± 0.00 0.02 ± 0.01 PRESTIGE 9 2 2 4 Yes Yes 0.13 ± 0.04 0.08 ± 0.00 0.13 ± 0.03 0.10 ± 0.06 PRESTIGE 10 2 2 4 Yes No 0.17 ± 0.04 0.16 ± 0.19 0.10 ± 0.05 0.11 ± 0.08 Abbreviations: NA, not available; Ra, average roughness; Wa, average waviness.
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