Ultra-high molecular polyethylene (UHMWPE) is one of the most used materials of the acetabular liners in total tip arthroplasty (THA). Polyethylene has good tribological properties and biocompatibility. However, the lifetime of polyethylene implants is limited by wear related complications. Polyethylene material released into the periprosthetic environment induces osteolysis that can be followed by implant loosening. Wear of cup is influenced mainly by orientation of the cup in pelvis, by initial geometry before the material degradation and by tribological parameters. Aim of this study is to focus on the run-in-phase of the liner which is predictive for future life cycles of liner. Creep deformations of liners for 30°, 45°, 60° inclination angles surgically recommended for the positioning in pelvis were analyzed by the optical scanning method. Load tests were performed for 50,000 cycles. Creep deformations and surface changes were analyzed at each 10,000 cycles. The results showed that liners with 60° inclination angle had higher creep deformations. Penetration of femoral head was 0.04-0.05 mm and occupied bearing area was around 77%. The smallest creep was measured for the 45° angle. However, deformation in the superior quadrant of acetabular rim, which is vulnerable for potential fracture of a liner, was identified in this case. Topography of the surface bearing was also observed during the run-in-phase. The surface was smoothened and showed multidirectional scratches caused by the influence of third body particles. This phase was followed by early delamination. Flakes sized approximately 5-20 µm were observed on the UHMWPE surface. This is similar to the'flake' shape wear debris extracted in vivo. Detailed analysis of run-in phase of loading of modern polyethylene implants can help to distinguish between their creep deformation and true degradation. The latter contributes strongly to the development of wear related complications associated with THAs limiting substantially their time in service.
Wear testing of total joint replacement (TJR) is mandatory in preclinical testing before implantation of TJR into the human body. Testing is governed by current international standards that recommend bovine serum (BS) as a lubricating fluid to replace synovial fluid (SF). Recently, the use of BS has been criticized because of differences in content, fluid characteristics, and nonhuman origin. As a result, a more realistic lubricant mimicking SF is needed. To define SF composition, we analyzed SF obtained during revisions of total hip and knee arthroplasties and compared it with SF obtained during primary arthroplasties and from patients without TJR. Samples were acquired from 152 patients. We found that the median total protein concentration for all SF was 36.8 mg/mL, which is significantly higher than concentrations currently recommended by the ISO standards. The γ-globulin concentration was significantly higher and the phospholipid concentration significantly lower in patients with revision of TJR compared with patients without TJR. No significant difference was found in hyaluronic acid concentration and viscosity among the groups. Our results support the need to improve the definition of a more clinically relevant wear testing lubricant in the ISO standards. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1422-1431, 2017.
- MeSH
- biomimetické materiály chemie MeSH
- dospělí MeSH
- fosfolipidy analýza metabolismus MeSH
- gama-globiny analýza metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- lubrikanty chemie MeSH
- náhrada kyčelního kloubu MeSH
- senioři MeSH
- synoviální tekutina chemie metabolismus MeSH
- totální endoprotéza kolene MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE OF THE STUDY By 7th December 2016, 4,755 Bicon-Plus cups in total were implanted in the Czech Republic. Some of them have been continuously re-operated, while the most frequent reason of failure is polyethylene wear and aseptic loosening. The present study is focused on surface analysis of retrieved polyethylene Bicon-Plus cups and the determination of the roughness of their bearing surfaces. MATERIAL AND METHODS In this study, we had 13 high molecular weight polyethylene cups with the average time in situ of 8.11 years (3.6-13.7, SD 3.2) before the retrieval. The study population was composed of 3 men, 10 women, with the mean age of 53.31 years. An optical scanning method, based on the principle of active triangulation, was used to determine wear rate. The rate of wear was identified by means of an obtained scan subsequently processed with the use of the GOM Inspect software. The roughness of surfaces was analysed with the application of Contour GT-X8 profiler using the principle of phase shifting interferometry. Measurements of surface topography of the retrieved cups were performed on the entire bearing surfaces. For the individual surface changes, a typical range of surface roughness, describing the particular wear character, was determined. By means of morphology analysis of the tested implants, three areas were identified: unworn area; area representing the worn part of the cup; and the area roughened by parallel grooving. The total surface roughness was evaluated as an arithmetic mean of the measured values. Subsequently, the values were sorted based on frequency and were classified into categories defining the particular wear mechanisms. RESULTS Wear rate of the retrieved acetabular cups was evaluated based on the wear direction vector and the size of linear wear. The average linear wear was equal to 0.13 mm/year (ranging from 0.26 to 2.29 mm/year), and the mean value of total volumetric material loss was 44.37 mm3/year (the range being from 51.80 to 1,119.7 mm3/year). Using the optical profilometer, a map of roughness distribution of the individual cups was obtained. For each implant, 76 values of roughness were evaluated. With the respect to average roughness, the samples were sorted to various categories describing: surface polishing; abrasiveadhesive wear; surfaces with preserved grooving; substantial plastic deformation. DISCUSSION The results clearly showed an increase of wear depending on implant survival; however, the tendency is not linear. This fact can be attributed to a larger amount of abrasive particles, causing an increase of wear or occurrence of surface wear in terms of micro cracks and oxidation degradation of polyethylene. This study indicates that geometry, positioning, and cup alignment during the implantation have a fundamental impact on the cup durability. Further correlation, which was observed in the case of the cup with prevailing roughness in the range from 0.1 to 0.3 μm, is a relatively wide wear vector angle determined with the use of the optical method. Considering the implants with the longest survival time with no loosening of the acetabular cup, the mean angle of direction vector was 56.8° (SD 2.1°). CONCLUSIONS The present study provides the results of morphology analysis of the retrieved Bicon-Plus cups. In general, relatively high wear rate, mainly of abrasive-adhesive character was identified. The dependence between wear and implant in situ longevity was not clearly linear, which suggests the influence of other parameters on the polyethylene wear rate. An important role of implant positioning on survival was also revealed. Moreover, it seems that it can be a more important parameter than the characteristics of the patient. Key words: total hip arthroplasty, Bicon-Plus cup, retrieval analysis, surface analysis, wear measurement, roughness, deformation, survivorship.
- MeSH
- analýza selhání vybavení MeSH
- kyčelní protézy * MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhrada kyčelního kloubu přístrojové vybavení MeSH
- polyethylen MeSH
- povrchové vlastnosti MeSH
- protézy - design MeSH
- selhání protézy * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
1 svazek : ilustrace ; 30 cm
The main problem concerning total hip arthroplasty (THA) is aseptic loosening and periprosthetic osteolysis, both are related to the type and rate of joint surface wear. Wear is not a primary function of joint materials but is a result of the interaction of various factors and conditions. These factors and conditions can be simulated at least partially in vitro and analyzed using optic colorimetric interferometry. The composition of joint fluid, pressure, speed and other parameters of the experiment will evolve from the real situation. Therefore analysis of real joint effusions acquired during reoperation/ implantation of THA is part of the proposed study. Results of the project will be exploitable in the construction of joint implants (material and constructive engineering), in clarifying differences in wear rates, survival of implants, and also in understanding the biologic reactions around THA. Therefore, the proposed project is fully in accordance with the R&D program MH Czech Republic.
Největším problémem totální endoprotézy (TEP) kyčle je aseptické uvolnění a periprotetická osteolýza, které jsou podmíněny typem a rychlostí otěru kloubních povrchů. Opotřebení není primární funkcí artikulačních materiálů, nýbrž důsledkem interakcí řady faktorů a podmínek. Tyto faktory a podmínky je možné dílem simulovat in vitro a studovat pomocí optické kolorimetrické interferometrie. Složení kloubní kapaliny, tlakové, rychlostní a další parametry experimentu budou vycházet z reálné situace. Proto je součástí navrhovaného projektu také analýza reálné kloubní kapaliny získané v průběhu reoperace/implantace TEP kyčle. Výstupy projektu budou využitelné při výrobě kloubních implantátů (materiálové a konstrukční inženýrství), při vysvětlení rozdílů v rychlosti opotřebení, přežití implantátu, resp. při pochopení biologických reakcí kolem TEP.
- MeSH
- biokompatibilní materiály MeSH
- kolorimetrie MeSH
- kyčelní protézy MeSH
- lubrikace MeSH
- náhrada kyčelního kloubu MeSH
- povrchové vlastnosti MeSH
- reoperace MeSH
- rozhraní kost/implantát MeSH
- synoviální tekutina MeSH
- Konspekt
- Ortopedie. Chirurgie. Oftalmologie
- NLK Obory
- ortopedie
- NLK Publikační typ
- závěrečné zprávy o řešení grantu IGA MZ ČR
The aim of the present paper is to provide a novel experimental approach enabling to assess the thickness of lubricant film within hip prostheses in meaning of the contribution of particular proteins. Thin film colorimetric interferometry was combined with fluorescent microscopy finding that a combination of optical methods can help to better understand the interfacial lubrication processes in hip replacements. The contact of metal femoral head against a glass disc was investigated under various operating conditions. As a test lubricant, the saline solution containing the albumin and γ-globulin in a concentration 2:1 was employed. Two different mean speeds were applied, 5.7 and 22mm/s, respectively. The measurements were carried out under pure rolling, partial negative and partial positive sliding conditions showing that kinematic conditions substantially affects the formation of protein film. Under pure rolling conditions, an increasing tendency of lubricant film independently on rolling speed was detected, while the total thickness of lubricant film can be attributed mainly to albumin. When the ball was faster than the disc (negative sliding), a very thin lubricant film was observed for lower speed with no significant effect of particular proteins. The increase in sliding speed led to the increase of film thickness mainly caused due to the presence of γ-globulin. On the contrary, when the disc was faster than the ball (positive sliding), the film formation was very complex and time dependent while both of the studied proteins have shown any qualitative change during the test, however the effect of albumin seems to be much more important. Since a very good agreement of the results was obtained, it can be concluded that the approach consisting of two optical methods can provide the fundamental information about the lubricant film formation in meaning of particular proteins while the simultaneous presence of other constituents in model synovial fluid.
An advanced surface engineering process combining micro-texture with a plasma carburising process was produced on CoCrMo femoral head, and their tribological properties were evaluated by the cutting-edge pendulum hip joint simulator coupled with thin film colorimetric interferometry. FESEM and GDOES showed that precipitation-free C S-phase with a uniform case depth of 10μm was formed across the micro-textures after duplex treatment. Hip simulator tests showed that the friction coefficient was reduced by 20% for micro-metre sized texture, and the long-term tribological property of microtexture was enhanced by the C-supersaturated crystalline microstructure formed on the surface of duplex treated CoCrMo, thereby enhancing biotribological durability significantly. In-situ colorimetric interferometry confirmed that the maximum film thickness around texture area was 530nm, indicating that the additional lubricant during sliding motion might provide exceptional bearing life.
Diamond like carbon (DLC) is applied as a thin film onto substrates to obtain desired surface properties such as increased hardness and corrosion resistance, and decreased friction and wear rate. Microdimple is an advanced surface modification technique enhancing the tribological performance. In this study, DLC coated microdimples were fabricated on hip prosthesis heads and their mechanical, material and surface properties were characterized. An Electro discharge machining (EDM) oriented microdrilling was utilized to fabricate a defined microdimple array (diameter of 300 µm, depth of 70 µm, and pitch of 900 µm) on stainless steel (SS) hip prosthesis heads. The dimpled surfaces were then coated by hydrogenated amorphous carbon (a-C:H) and tetrahedral amorphous carbon (Ta-C) layers by using a magnetron sputtering technology. A preliminary tribology test was conducted on these fabricated surfaces against a ceramic ball in simulated hip joint conditions. It was found that the fabricated dimples were perpendicular to the spherical surfaces and no cutting-tools wear debris was detected inside the individual dimples. The a-C:H and Ta-C coatings increased the hardness at both the dimple edges and the nondimpled region. The tribology test showed a significant reduction in friction coefficient for coated surfaces regardless of microdimple arrays: the lowest friction coefficient was found for the a-C:H samples (µ = 0.084), followed by Ta-C (µ = 0.119), as compared to the SS surface (µ = 0.248).
- MeSH
- biokompatibilní potahované materiály chemie MeSH
- kyčelní protézy * MeSH
- lidé MeSH
- povrchové vlastnosti MeSH
- uhlík chemie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE OF THE STUDY: The wear of articular surfaces is considered one of the most important factors limiting the life of total hip arthroplasty (THA). It is assumed that the particles released from the surface of a softer material induce a complex inflammatory response, which will eventually result in osteolysis and aseptic loosening. Implant wear is related to a friction coefficient which depends on combination of the materials used, roughness of the articulating surfaces, internal clearance, and dimensions of the prosthesis. MATERIAL AND METHODS: The selected parameters of the bearing couples tested were studied using an experimental device based on the principle of a pendulum. Bovine serum was used as a lubricant and the load corresponded to a human body mass of 75 kg. The friction coefficient was derived from a curve of slowdown of pendulum oscillations. Roughness was measured with a device working on the principle of interferometry. Clearance was assessed by measuring diameters of the acetabular and femoral heads with a 3D optical scanner. The specimens tested included unused metal-on-highly cross-linked polyethylene, ceramic-on-highly cross-linked polyethylene and ceramic-on-ceramic bearing couples with the diameters of 28 mm and 36 mm. For each measured parameter, an arithmetic mean was calculated from 10 measurements. RESULTS: 1) The roughness of polyethylene surfaces was higher by about one order of magnitude than the roughness of metal and ceramic components. The Protasul metal head had the least rough surface (0.003 μm). 2) The ceramic-on-ceramic couples had the lowest clearance. Bearing couples with polyethylene acetabular liners had markedly higher clearances ranging from 150 μm to 545 μm. A clearance increased with large femoral heads (up to 4-fold in one of the couple tested). 3) The friction coefficient was related to the combination of materials; it was lowest in ceramic-on-ceramic surfaces (0.11 to 0.12) and then in ceramic-on-polyethylene implants (0.13 to 0.14). The friction coefficient is supposed to increase with a decreasing femoral head diameter. However, in the bearing couples with polyethylene liners manufactured by one company, paradoxically, the friction coefficient slightly increased with an increase in femoral head size from 28 mm to 36 mm. 4) The lowest friction moment (< 3.5 Nm) was found for ceramic-on-ceramic implants 28 mm in diameter; the highest values were recorded in metal-on-polyethylene bearing couples 36 mm in diameter (> 7 Nm). DISCUSSION: Although our study confirmed that the bearing couples produced by different manufacturers varied to some extent in the parameters studied, in our opinion, this variability was not significant because it was not within an order of magnitude in any of the tests. CONCLUSIONS: The study showed that both the friction coefficient and the friction moment are affected more by the combination of materials than by the diameter of a femoral head. The best results were achieved in ceramic-on-ceramic implants.
This study investigates a tribological performance of diamond like carbon (DLC) coated micro dimpled prosthesis heads against ceramic cups in a novel pendulum hip joint simulator. The simulator enables determining friction coefficient and viscous effects of a concave shaped specimen interface (conformal contact). Two types of DLC such as hydrogenated amorphous carbon (a-C:H) and tetrahedral amorphous carbon (Ta-C) and one set of micro dimple (diameter of 300µm, depth of 70µm, and pitch of 900µm) were fabricated on metallic prosthesis heads. The experiment results reveal a significant friction coefficient reduction to the 'dimpled a-C:H/ceramic' prosthesis compared to a 'Metal (CoCr)/ceramic' prosthesis because of their improved material and surface properties and viscous effect. The post-experiment surface analysis displays that the dimpled a-C:H yielded a minor change in the surface roughness, and generated a larger sizes of wear debris (40-200nm sized, equivalent diameter), a size which could be certainly stored in the dimple, thus likely to reducing their possible third body abrasive wear rate. Thus, dimpled a:C-H can be used as a 'metal on ceramic hip joint interface', whereas the simulator can be utilized as an advanced bio-tribometer.
The aim of this study is to consider the relevance of in situ measurements of bovine serum film thickness in the optical test device that could be related to the function of the artificial hip joint. It is mainly focussed on the effect of the hydrophobicity or hydrophilicity of the transparent surface and the effect of its geometry. Film thickness measurements were performed using ball-on-disc and lens-on-disc configurations of optical test device as a function of time. Chromatic interferograms were recorded with a high-speed complementary metal-oxide semiconductor digital camera and evaluated with thin film colorimetric interferometry. It was clarified that a chromium layer covering the glass disc has a hydrophobic behaviour which supports the adsorption of proteins contained in the bovine serum solution, thereby a thicker lubricating film is formed. On the contrary, the protein film formation was not observed when the disc was covered with a silica layer having a hydrophilic behaviour. In this case, a very thin lubricating film was formed only due to the hydrodynamic effect. Metal and ceramic balls have no substantial effect on lubricant film formation although their contact surfaces have relatively different wettability. It was confirmed that conformity of contacting surfaces and kinematic conditions has fundamental effect on bovine serum film formation. In the ball-on-disc configuration, the lubricant film is formed predominantly due to protein aggregations, which pass through the contact zone and increase the film thickness. In the more conformal ball-on-lens configuration, the lubricant film is formed predominantly due to hydrodynamic effect, thereby the film thickness is kept constant during measurement.
- MeSH
- adsorpce MeSH
- biomechanika MeSH
- hydrofobní a hydrofilní interakce MeSH
- interferometrie metody MeSH
- kyčelní protézy * MeSH
- lubrikanty chemie MeSH
- sérum chemie MeSH
- skot MeSH
- smáčivost MeSH
- testování materiálů metody MeSH
- zvířata MeSH
- Check Tag
- skot MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
