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Ashkanfar A, Toh SMS, English R, Langton DJ, Joyce TJ. The impact of femoral head size on the wear evolution at contacting surfaces of total hip prostheses: A finite element analysis. J Mech Behav Biomed Mater 2024; 153:106474. [PMID: 38447273 DOI: 10.1016/j.jmbbm.2024.106474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
Total Hip Arthroplasty has been a revolutionary technique in restoring mobility to patients with damaged hip joints. The introduction of modular components of the hip prosthesis allowed for bespoke solutions based on the requirements of the patient. The femoral stem is designed with a conical trunnion to allow for assembly of different femoral head sizes based on surgical requirements. The femoral head diameters for a metal-on-polyethylene hip prosthesis have typically ranged between 22 mm and 36 mm and are typically manufactured using Cobalt-Chromium alloy. A smaller femoral head diameter is associated with lower wear of the polyethylene, however, there is a higher risk of dislocation. In this study, a finite element model of a standard commercial hip arthroplasty prosthesis was modelled with femoral head diameters ranging from 22 mm to 36 mm to investigate the wear evolution and material loss at both contacting surfaces (acetabular cup and femoral stem trunnion). The finite element model, coupled with a validated in-house wear algorithm modelled a human walking for 10 million steps. The results have shown that as the femoral head size increased, the amount of wear on all contacting surfaces increased. As the femoral head diameter increased from 22 mm to 36 mm, the highly cross-linked polyethylene (XLPE) volumetric wear increased by 61% from 98.6 mm3 to 159.5 mm3 while the femoral head taper surface volumetric wear increased by 21% from 4.18 mm3 to 4.95 mm3. This study has provided an insight into the amount of increased wear as the femoral head size increased which can highlight the life span of these prostheses in the human body.
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Affiliation(s)
- Ariyan Ashkanfar
- School of Engineering, Liverpool John Moores University, Liverpool, UK
| | | | - Russell English
- School of Engineering, Liverpool John Moores University, Liverpool, UK
| | | | - Thomas J Joyce
- School of Engineering, Newcastle University, Newcastle Upon Tyne, UK
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Saikko V. Statistical analysis of VEXLPE wear against alumina produced by a new 200-station, multidirectional pin-on-disk device. Proc Inst Mech Eng H 2024; 238:438-443. [PMID: 38439747 DOI: 10.1177/09544119241235789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
With low wear rates shown by contemporary bearing materials of total hip prostheses, the standard deviation of wear rate is relatively high. Therefore, large sample sizes are needed for an adequate power of test. Because wear tests take a long time, it is practical to test several samples simultaneously. A new high-capacity, multidirectional wear test device, called the SuperCTPOD-200, was introduced. A 3 million-cycle wear test with an unprecedented sample size of 200 was performed for VEXLPE. The duration of the test was 6 weeks. The wear factor was normally distributed with a mean ± SD of 1.64 × 10-7 mm3/Nm ± 0.22 × 10-7 mm3/Nm (n = 200). The observation that SD was 13.1% of the mean can be useful in power analyses of future tests with other highly cross-linked polyethylenes. Burnishing was the most typical feature on the worn pins, which was in agreement with clinical findings on retrieved acetabular liners. The present study emphasizes statistics that often plays a minor role only in wear studies.
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Affiliation(s)
- Vesa Saikko
- Department of Mechanical Engineering, Aalto University, Espoo, Finland
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Hidayat T, Ismail R, Tauviqirrahman M, Saputra E, Ammarullah MI, Lamura MDP, Bayuseno AP, Jamari. Running-in behavior of dual-mobility cup during the gait cycle: A finite element analysis. Proc Inst Mech Eng H 2024; 238:99-111. [PMID: 38156402 DOI: 10.1177/09544119231216023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
The running-in process is considered an essential aspect of the comprehensive wear process. The phenomenon of running-in occurs during the initial stages of wear in the prosthetic hip joint. Within the field of tribology, the running-in phenomenon of the hip joint pertains to the mechanism by which the contact surfaces of the artificial hip joint components are adjusted and a suitable lubricating film is formed. During the process of hip joint running-in, there is an interaction between the metal surface of the ball and the joint cup, which results in adjustments being made until a steady state is achieved. The achievement of desirable wear existence and reliable performance of artificial hip joint components are reliant upon the tribological running-in of the hip joint. Despite the establishment of current modeling approaches, there remains a significant lack of understanding concerning running-in wear, particularly the metal-on-polyethylene (MoP) articulations in dual-mobility cups (DMC). An essential aspect to consider is the running-in phase of the dual mobility component. The present study employed finite element analysis to investigate the running-in behavior of dual mobility cups, wherein femoral head components were matched with polyethylene liners of varying thicknesses. The analysis of the running-in phase was conducted during the normal gait cycle. The results of this investigation may be utilized to design a dual-mobility prosthetic hip joint that exhibits minimal running-in wear.
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Affiliation(s)
- Taufiq Hidayat
- Department of Mechanical Engineering, Diponegoro University, Semarang, Central Java, Indonesia
- Department of Mechanical Engineering, Universitas Muria Kudus, Kudus, Central Java, Indonesia
| | - Rifky Ismail
- Department of Mechanical Engineering, Diponegoro University, Semarang, Central Java, Indonesia
- Center for Biomechanics Biomaterials Biomechatronics and Biosignal Processing (CBIOM3S) Diponegoro University, Semarang, Central Java, Indonesia
| | - Mohammad Tauviqirrahman
- Department of Mechanical Engineering, Diponegoro University, Semarang, Central Java, Indonesia
| | - Eko Saputra
- Department of Mechanical Engineering, Semarang State Polytechnic, Semarang, Central Java, Indonesia
| | - Muhammad Imam Ammarullah
- Biomechanics and Biomedics Engineering Research Centre, Universitas Pasundan, Bandung, West Java, Indonesia
| | - M Danny Pratama Lamura
- Department of Mechanical Engineering, Diponegoro University, Semarang, Central Java, Indonesia
- Undip Biomechanics Engineering & Research Centre (UBM-ERC), Diponegoro University, Semarang, Central Java, Indonesia
| | | | - Jamari
- Department of Mechanical Engineering, Diponegoro University, Semarang, Central Java, Indonesia
- Undip Biomechanics Engineering & Research Centre (UBM-ERC), Diponegoro University, Semarang, Central Java, Indonesia
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Merfort R, Maffulli N, Hofmann UK, Hildebrand F, Simeone F, Eschweiler J, Migliorini F. Head, acetabular liner composition, and rate of revision and wear in total hip arthroplasty: a Bayesian network meta-analysis. Sci Rep 2023; 13:20327. [PMID: 37989863 PMCID: PMC10663607 DOI: 10.1038/s41598-023-47670-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/16/2023] [Indexed: 11/23/2023] Open
Abstract
Total hip arthroplasty (THA) is a common procedure for patients suffering from hip pain e.g. from osteoarthritis, osteonecrosis, or hip fractures. The satisfaction of patients undergoing THA is influenced by the choice of implant type and material, with one key factor being the selection of the appropriate material combination for the bearing surface. In this Bayesian network meta-analysis, we investigated the impact of material combinations for the bearing surface on the longevity of hip implants. The wear penetration rate per year and the total wear penetration in the liner resulting from different material combinations, as well as the survival rate at last follow-up, were examined. We analyzed a total of 663,038 THAs, with 55% of patients being women. Mean patient age was 59.0 ± 8.1 years and mean BMI 27.6 ± 2.6 kg/m2. The combination of an aluminium oxide (Al2O3) head and an Al2O3 liner demonstrated the lowest wear penetration at last follow-up and the lowest rate of wear penetration per year. Additionally, the combination of a crosslinked polyethylene (XLPE) liner and a zircon oxide (ZrO2) head demonstrated the lowest rate of revision at last follow-up. These findings underscore the importance of careful material selection for hip implant bearing surfaces to optimize their longevity and patient satisfaction after THA.
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Affiliation(s)
- Ricarda Merfort
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074, Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine and Psicology, University La Sapienza, Rome, Italy
- Faculty of Medicine, School of Pharmacy and Bioengineering, Keele University, Thornburrow Drive, Stoke-on-Trent, England, UK
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England, UK
| | - Ulf Krister Hofmann
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074, Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074, Aachen, Germany
| | - Francesco Simeone
- Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy
| | - Jörg Eschweiler
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074, Aachen, Germany.
- Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy.
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Hidayat T, Jamari J, Bayuseno A, Ismail R, Tauviqirrahman M, Saputra E. Short communication: Running-in behavior on single-mobility total hip arthroplasty. Med Eng Phys 2022; 104:103806. [DOI: 10.1016/j.medengphy.2022.103806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/01/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
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Wight CM, Schemitsch EH. In vitro testing for hip head-neck taper tribocorrosion: A review of experimental methods. Proc Inst Mech Eng H 2022; 236:9544119221074582. [PMID: 35139678 PMCID: PMC8915230 DOI: 10.1177/09544119221074582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In vitro test methods are challenged by the multi-factorial nature of head-neck taper connection tribocorrosion due to the consequences of simplification. Incorrect study design and misinterpretation of results has led to contradictory findings regarding important factors affecting head-neck taper tribocorrosion. This review seeks to highlight important considerations when developing in vitro test methods, to help researchers strengthen their study design and analyze the implications of others' design decisions. The advantages, disadvantages, limitations and procedural considerations for finite element analyses, electrochemical studies and in vitro simulations related to head-neck taper connection tribocorrosion are discussed. Finite element analysis offers an efficient method for studying large ranges of mechanical parameters. However, they are limited by neglecting electrochemical, biological and fluid flow factors. Electrochemical studies may be preferred if these factors are considered important. Care must be taken in interpreting data from electrochemical studies, particularly when different materials are compared. Differences in material valence and toxicity affect clinical translation of electrochemical studies' results. At their most complex, electrochemical studies attempt to simulate all aspects of headneck taper connection tribocorrosion in a bench top study. Effective execution requires in-depth knowledge of the tribocorrosion phenomenon, the involved mechanisms, and their measures such that each study design decision is fully informed.
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Affiliation(s)
- Christian M Wight
- Institute of Biomaterial and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Emil H Schemitsch
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
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Wight CM, Whyne CM, Bogoch ER, Zdero R, Chapman RM, van Citters DW, Walsh WR, Schemitsch E. Effect of head size and rotation on taper corrosion in a hip simulator. Bone Jt Open 2021; 2:1004-1016. [PMID: 34825826 PMCID: PMC8636299 DOI: 10.1302/2633-1462.211.bjo-2021-0147.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
AIMS This study investigates head-neck taper corrosion with varying head size in a novel hip simulator instrumented to measure corrosion related electrical activity under torsional loads. METHODS In all, six 28 mm and six 36 mm titanium stem-cobalt chrome head pairs with polyethylene sockets were tested in a novel instrumented hip simulator. Samples were tested using simulated gait data with incremental increasing loads to determine corrosion onset load and electrochemical activity. Half of each head size group were then cycled with simulated gait and the other half with gait compression only. Damage was measured by area and maximum linear wear depth. RESULTS Overall, 36 mm heads had lower corrosion onset load (p = 0.009) and change in open circuit potential (OCP) during simulated gait with (p = 0.006) and without joint movement (p = 0.004). Discontinuing gait's joint movement decreased corrosion currents (p = 0.042); however, wear testing showed no significant effect of joint movement on taper damage. In addition, 36 mm heads had greater corrosion area (p = 0.050), but no significant difference was found for maximum linear wear depth (p = 0.155). CONCLUSION Larger heads are more susceptible to taper corrosion; however, not due to frictional torque as hypothesized. An alternative hypothesis of taper flexural rigidity differential is proposed. Further studies are necessary to investigate the clinical significance and underlying mechanism of this finding. Cite this article: Bone Jt Open 2021;2(11):1004-1016.
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Affiliation(s)
- Christian M Wight
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Cari M Whyne
- Orthopaedic Biomechanics Laboratory, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Earl R Bogoch
- Department of Surgery, University of Toronto, Brookfield Chair in Fracture Prevention, Toronto, Ontario, Canada
| | - Radovan Zdero
- London Health Science Centre, Western University, London, Ontario, Canada
| | - Ryan M Chapman
- London Health Science Centre, Western University, London, Ontario, Canada
| | - Douglas W van Citters
- Thayer School of Engineering at Dartmouth College, Western University, Hanover, New Hampshire, USA
| | - William R Walsh
- Surgical and Orthopaedic Research Laboratory, UNSW Prince of Wales Clinical School, Randwick, New South Wales, Australia
| | - Emil Schemitsch
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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