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Million cycle stage (Figure 2).It has been reported that the DHT devices generate smaller size particles and in much largernumbers compared to those generated by the AC devices. This would result in a larger netsurface area of the wear particles exposed to corrosion and thus would contribute to a higheramount of metal ion levels with the DHT devices compared to AC devices.Conclusion: The in vitro results obtained with the new test protocol correlate well with the invivo results. The higher wear, metal ion levels observed with double heat treated CoCr devicescompared to as cast CoCr in vivo were also represented in vitro, highlighting the effect ofmicrostructure on wear.FiguresSaturday, October 9, 2010, 7:45-8:50Session B16: Performance and Survivorship in ArthroplastyJapanese Success of Deep Knee Flexion in Total Knee Arthroplasty.*Koichi Kanekasu - Saiseikai Takaoka Hospital - Takaoka, Japan*Email: knks@p1.tcnet.ne.jpKneeling is one of important motion in Asians culture, also there were teachers of tea or flowerceremony who sit seiza routinely. But also, people in the Middle East need deep flexion keelingwhen they pray. At the symposium with the title of “A Challenge of deep flexion after TKA”,held at the 33rd Annual Meeting of Japanese Society of Reconstructive Arthroplasty in 2003, itwas agreed that the definition of post-operative deep flexion to be more than 130 degrees offlexion.Four hundred and seventy two patients treated with a total of 598 consecutive primarytotal knee arthroplasties were performed and 480 knees were followed for 4.1 to 10.6 years(mean, 7.2 years). Preoperatively, the mean Hospital for Special Surgery knee score was 45.8points. At the time of latest follow-up, the mean knee score was 88.5 points. The meanpreoperative and postoperative ranges of flexion were 116 and 134 degrees, respectively. Noknee developed osteolysis, aseptic loosening. A revision operation was performed in 3 kneesbecause of infection.Achieving deep flexion is multi-factorial, such as preoperative planning,surgical procedure, prosthesis design, and postoperative rehabilitation. About surgical tips fordeep flexion, posterior positioning of femoral component will increase the femoral posterioroffset and decrease the anterior patello-femoral pressure. Through osteophyte removal willincrease the posterior clearance and avoid the bone-polyethylene impingement. The flexion gapshould be balanced after creating a balanced extension gap, since preparation of the flexion gapaffects the extension gap in TKA.Based upon studies of the healthy knee in deep flexion, it washypothesized that deep flexion would require tibial internal rotation greater than 20 degrees,greater posterior translation of the lateral femoral condyle than the medial condyle, andsubluxation of the articular surfaces in terminal flexion. However, as the results of ourfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]