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Nguyen QM, Otsuka Y, Miyashita Y. A finite element study on the interactive effect between the damage of the cup-bone interface and the bone strain of hip implants under various fixation conditions. J Mech Behav Biomed Mater 2023; 144:105945. [PMID: 37329674 DOI: 10.1016/j.jmbbm.2023.105945] [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: 02/21/2023] [Revised: 05/12/2023] [Accepted: 05/30/2023] [Indexed: 06/19/2023]
Abstract
Interfacial damage has a high impact on the loosening of the acetabular cup. However, monitoring this damage induced by the variations in loading conditions, such as the angle, amplitude, and frequency in vivo, is challenging. In this study, we evaluated the risk of loosening of the acetabular cup due to interfacial damages induced by the deviation in loading conditions and amplitudes. A three-dimensional model of the acetabular cup component was developed, and the interfacial crack growth between the cup and the bone was modeled using a fracture mechanics approach, which simulated the extent of interfacial damage and associated cup displacement. The interfacial delamination mechanism changed with the increasing inclination angle, wherein a fixation angle of 60° exhibited the largest area of contact loss. The compressive strain of embedding the simulated bone at the remaining bonding area accumulated as the lost contact area widened. Such interfacial damages, namely, the growth of the lost contact area and accumulated compressive strain in the simulated bone, promoted both embedding and rotational displacement of the acetabular cup. In the worst case of a fixation angle of 60°, the total displacement of the acetabular cup exceeded the limit of the modified safe zone, suggesting a quantitative risk of dislocation of the acetabular cup induced by the accumulated interfacial damage. Furthermore, nonlinear regression analyses between the degree of displacement of the acetabular cup and the extent of the two types of interfacial damage demonstrated that the interactive effect of the fixation angle with the loading amplitude showed a significant effect on increasing cup displacement. These findings suggest that proper control of the fixation angle during operation is useful in preventing the loosening of the hip joint.
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Affiliation(s)
- Quang Minh Nguyen
- Graduate School of Mechanical Engineering, Nagaoka University of Technology, 1603-1 Kamitomioka, Nagaoka-shi, Niigata 940-2188, Japan
| | - Yuichi Otsuka
- Department of System Safety, Nagaoka University of Technology, 1603-1 Kamitomioka, Nagaoka-shi, Niigata 940-2188, Japan.
| | - Yukio Miyashita
- Graduate School of Mechanical Engineering, Nagaoka University of Technology, 1603-1 Kamitomioka, Nagaoka-shi, Niigata 940-2188, Japan
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Li D, Wang S, Lin H, Wang K, Guo Y, Yu L, Fang X. Effect of synovial fluid temperature on wear resistance of different polymer acetabular materials. J Biomater Appl 2023; 37:1736-1757. [PMID: 36927235 DOI: 10.1177/08853282231163678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
In order to investigate the effect of frictional heat on the wear resistance characteristics of polymeric acetabular materials, the tribological tests and wear numerical analysis of three common polymer acetabular materials were carried out under different synovial fluid temperatures. The study results show that XLPE and VE-XLPE exhibit superior wear resistance compared to UHMWPE in high-temperature, heavy load environments. The coefficient of friction of three materials gradually decreases as the temperature of the synovial fluid increases. The wear depth and wear volume of the three materials increased with the increase of the temperature of the synovial fluid, and the forms of wear at 46°C and 55°C were mainly adhesive wear and plastic deformation. The higher temperature of the synovial fluid accelerates the oxidative degradation of the material surface and generates oxidation functional groups, which leads to the breakage of C-C bonds in the surface molecular chains under the sliding shear effect, thus reducing the mechanical properties of the material. Specifically, the surface of the polymer material will soften at a higher ambient temperature, mainly due to the decrease of hardness, and then deteriorate in the friction property, and finally increase the wear rate. Ansys results showed that the volume wear of the three materials increased with the increase of synovial fluid temperature, and the trend could be approximately linear. Numerical calculations predict that VE-XLPE has the highest wear of 0.693 mm3 among the three materials at 37°C, followed by XLPE at 0.568 mm3 and UHMWPE with the lowest wear of 0.478 mm3. At higher synovial fluid temperatures (46°C, 55°C), VE-XLPE still has the largest wear volume among the three materials, while XLPE and UHMWPE have similar wear. The wear cloud pictures showed that the maximum wear volume occurred near the edge of the acetabulum.
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Affiliation(s)
- Dahan Li
- Center for Tribology, School of Mechatronic Engineering, 12675Jiangsu Normal University, Xuzhou, Jiangsu Province, China
| | - Songquan Wang
- Center for Tribology, School of Mechatronic Engineering, 12675Jiangsu Normal University, Xuzhou, Jiangsu Province, China
| | - Hao Lin
- Center for Tribology, School of Mechatronic Engineering, 12675Jiangsu Normal University, Xuzhou, Jiangsu Province, China
| | - Kaijun Wang
- Center for Tribology, School of Mechatronic Engineering, 12675Jiangsu Normal University, Xuzhou, Jiangsu Province, China
| | - Yongbo Guo
- Center for Tribology, School of Mechatronic Engineering, 12675Jiangsu Normal University, Xuzhou, Jiangsu Province, China
| | - Lu Yu
- Center for Tribology, School of Mechatronic Engineering, 12675Jiangsu Normal University, Xuzhou, Jiangsu Province, China
| | - Xingxing Fang
- Center for Tribology, School of Mechatronic Engineering, 12675Jiangsu Normal University, Xuzhou, Jiangsu Province, China
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Analysis of the Risk of Wear on Cemented and Uncemented Polyethylene Liners According to Different Variables in Hip Arthroplasty. MATERIALS 2021; 14:ma14237243. [PMID: 34885400 PMCID: PMC8658086 DOI: 10.3390/ma14237243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022]
Abstract
Wear debris in total hip arthroplasty is one of the main causes of loosening and failure, and the optimal acetabular fixation for primary total hip arthroplasty is still controversial because there is no significant difference between cemented and uncemented types for long-term clinical and functional outcome. To assess and predict, from a theoretical viewpoint, the risk of wear with two types of polyethylene liners, cemented and uncemented, a simulation using the finite element (FE) method was carried out. The risk of wear was analyzed according to different variables: the polyethylene acetabular component’s position with respect to the center of rotation of the hip; the thickness of the polyethylene insert; the material of the femoral head; and the relationship of the cervical–diaphyseal morphology of the proximal end of the femur to the restoration of the femoral offset. In all 72 simulations studied, a difference was observed in favour of a cemented solution with respect to the risk of wear. With regard to the other variables, the acetabular fixation, the thickness of the polyethylene, and the acetabular component positioning were statistically significant. The highest values for the risk of wear corresponded to a smaller thickness (5.3 mm), and super-lateral positioning at 25 mm reached the highest value of the von Mises stress. According to our results, for the reconstruction of the acetabular side, a cemented insert with a thickness of at least 5 mm should be used at the center of rotation.
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Cheung A, Yan CH, Fu H, Cheung MH, Chan PK, Chiu KY. Ten- to Sixteen-Year Follow-Up of Highly Cross-Linked Polyethylene in Total Hip Arthroplasty: What Factors Affect Wear? J Arthroplasty 2019; 34:2016-2021. [PMID: 31176564 DOI: 10.1016/j.arth.2019.04.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/16/2019] [Accepted: 04/22/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Increase in acetabular cup abduction in total hip arthroplasty (THA) using conventional polyethylene is associated with greater linear wear. Whether this relationship holds true for highly crosslinked liners, particularly with long-term follow-up, is still controversial. The effect of liner thickness on wear of highly cross-linked liners also remains to be clarified.This study sought to determine (1) the long-term clinical and radiological performance of highly cross-linked polyethylene in THA and (2) the effect of acetabular component positioning, polyethylene thickness, and patient demographics on wear. METHODS Ninety-three THAs using a 28-mm hip ball, single brand of highly cross-linked polyethylene liner, and cementless cup were performed in 87 patients. Clinical outcomes were evaluated using the Harris Hip Score and need for revision surgery. Linear and volumetric wear, presence of osteolysis, and cup abduction angle were assessed. RESULTS The mean age at operation was 51.4 years. The mean duration of follow-up was 12.7 years (10-16 years). Patients aged >50 years had higher rates of linear wear than those aged <50 years (P = .015). Positive correlation was found between cup abduction angle (P = .014) and cup version (P = .035) with a linear wear rate. Thinner liners (≤7 mm) had similar rates of linear and volumetric wear as thicker liners (≥8 mm) (P = .447). CONCLUSION This is the only study to demonstrate a positive significant relationship between cup abduction angle and version with linear wear rate in THA with at least 10 years of follow-up. Liner thickness was not found to affect wear rates.
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Affiliation(s)
- Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Femoral Head Penetration Rates of Second-Generation Sequentially Annealed Highly Cross-Linked Polyethylene at Minimum Five Years. J Arthroplasty 2019; 34:781-788. [PMID: 30609952 DOI: 10.1016/j.arth.2018.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/19/2018] [Accepted: 12/04/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Highly cross-linked polyethylene (HXLPE) liners in total hip arthroplasty (THA) have demonstrated decreased wear rates, resilience to cup orientation, and reduced osteolysis compared to conventional polyethylene. Sequential irradiation and annealing below the melting temperature is unique compared to most HXLPE which is irradiated and remelted. This study purpose is to provide minimum 5-year femoral head penetration rates of sequentially annealed HXLPE in primary THA. METHODS A retrospective review of a prospectively collected database identified 198 consecutive, cementless primary THAs utilizing sequentially annealed HXLPE (X3; Stryker, Mahwah, NJ). Operative technique was standardized. Radiographs were analyzed utilizing the Martell method with minimum 5-year and 1-year radiographs as baseline to minimize the initial bedding-in period. RESULTS Seventy-seven hips with minimum 5-year follow-up were analyzed. Mean steady state linear and volumetric head penetration rates were 0.095 mm/y and 76 mm3/y, respectively. Volumetric head penetration was significantly less for 32-mm compared to 36-mm (P = .028). In addition, less head penetration was observed for ceramic 32-mm heads at nearly half the rate compared to cobalt-chromium 36-mm heads (P ≥ .092). No correlations existed between penetration rates and age, body mass index, University of California Los Angeles Activity Level, polyethylene thickness, cup inclination, or anteversion (P ≥ .10). No radiographic osteolysis was observed. CONCLUSION Surprisingly, linear head penetration rates of sequentially annealed HXLPE were nearly identical to the osteolysis threshold for conventional polyethylene and greater than reports of irradiated and remelted HXLPE. Furthermore, these data corroborate reports that HXLPE is resilient to cup orientation and demographic variables. Longer term follow-up is recommended.
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Materials for Hip Prostheses: A Review of Wear and Loading Considerations. MATERIALS 2019; 12:ma12030495. [PMID: 30764574 PMCID: PMC6384837 DOI: 10.3390/ma12030495] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 01/31/2019] [Accepted: 01/31/2019] [Indexed: 12/15/2022]
Abstract
Replacement surgery of hip joint consists of the substitution of the joint with an implant able to recreate the articulation functionality. This article aims to review the current state of the art of the biomaterials used for hip implants. Hip implants can be realized with different combination of materials, such as metals, ceramics and polymers. In this review, we analyze, from international literature, the specific characteristics required for biomaterials used in hip joint arthroplasty, i.e., being biocompatible, resisting heavy stress, opposing low frictional forces to sliding and having a low wear rate. A commentary on the evolution and actual existing hip prostheses is proposed. We analyzed the scientific literature, collecting information on the material behavior and the human-body response to it. Particular attention has been given to the tribological behavior of the biomaterials, as friction and wear have been key aspects to improve as hip implants evolve. After more than 50 years of evolution, in term of designs and materials, the actual wear rate of the most common implants is low, allowing us to sensibly reduce the risk related to the widespread debris distribution in the human body.
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Nithyaprakash R, Shankar S, Uddin MS. Computational wear assessment of hard on hard hip implants subject to physically demanding tasks. Med Biol Eng Comput 2017; 56:899-910. [PMID: 29094238 DOI: 10.1007/s11517-017-1739-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 10/04/2017] [Indexed: 12/29/2022]
Abstract
Hip implants subject to gait loading due to occupational activities are potentially prone to failures such as osteolysis and aseptic loosening, causing painful revision surgeries. Highly risky gait activities such as carrying a load, stairs up or down and ladder up or down may cause excessive loading at the hip joint, resulting in generation of wear and related debris. Estimation of wear under the above gait activities is thus crucial to design and develop a new and improved implant component. With this motivation, this paper presents an assessment of wear generation of PCD-on-PCD (poly crystalline diamond) hip implants using finite element (FE) analysis. Three-dimensional (3D) FE model of hip implant along with peak gait and peak flexion angle for each activity was used to estimate wear of PCD for 10 million cycles. The maximum and minimum initial contact pressures of 206.19 MPa and 151.89 MPa were obtained for carrying load of 40 kg and sitting down or getting up activity. The simulation results obtained from finite element model also revealed that the maximum linear wear of 0.585 μm occurred for the patients frequently involved in sitting down or getting up gait activity and maximum volumetric wear of 0.025 mm3 for ladder up gait activity. The stair down activity showed the least linear and volumetric wear of 0.158 μm and 0.008 mm3, respectively, at the end of 10 million cycles. Graphical abstract Computational wear assessment of hip implants subjected to physically demanding tasks.
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Affiliation(s)
- R Nithyaprakash
- Department of Mechatronics Engineering, Kongu Engineering College, Erode, Tamil Nadu, 638052, India.
| | - S Shankar
- Department of Mechatronics Engineering, Kongu Engineering College, Erode, Tamil Nadu, 638052, India
| | - M S Uddin
- School of Engineering, University of South Australia, Mawson Lakes Campus, Mawson Lakes, SA, 5095, Australia
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Oshima H, Tanaka S, Takatori Y, Tanaka T, Ishikura H, Moro T. Clinical and Radiographic Outcomes of Total Hip Arthroplasty With a Specific Liner in Small Asian Patients: Influence of Patient-Related, Implant-Related, and Surgical Factors on Femoral Head Penetration. J Arthroplasty 2017; 32:3065-3070. [PMID: 28579445 DOI: 10.1016/j.arth.2017.04.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/23/2017] [Accepted: 04/24/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND We evaluated the clinical and radiographic outcomes, including femoral head penetration, of total hip arthroplasty performed using a specific polyethylene (PE) liner in small Asian patients at 10 years after the index surgery. In addition, we investigated whether femoral head penetration was affected by patient-related, implant-related, and surgical factors. METHODS Between August 2002 and June 2005, for cementless primary total hip arthroplasty, we used acetabular PE liners that were manufactured from GUR 1050 resin, machined from isostatic compression-molded bar stock, and sterilized with a gamma ray irradiation in argon gas. We assessed 82 hips in 78 patients who received these liners. RESULTS The mean Harris hip score improved from 41.0 preoperatively to 84.5 at 10 years postoperatively. Periprosthetic osteolysis was observed in 7 hips (9.8%). No acetabular component migration was detected, and no revision surgery was performed 10 years postoperatively. The mean steady-state wear rate was 0.031 mm/y, which was lower than the wear rate for other conventional PE liners of the previous studies. Among the patient-related, implant-related, and surgical factors, sex was significantly associated with the mean steady-state wear rate, with a higher rate in male patients than in female patients. CONCLUSION PE acetabular liners used in small Asian patients show similar clinical outcomes and reduced wear compared with those of other liners. In addition, sex is significantly associated with the mean steady-state wear rate, and the steady-state wear rate is higher in male patients than in female patients.
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Affiliation(s)
- Hirofumi Oshima
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshio Takatori
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeyuki Tanaka
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisatoshi Ishikura
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toru Moro
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Goyal P, Howard JL, Yuan X, Teeter MG, Lanting BA. Effect of Acetabular Position on Polyethylene Liner Wear Measured Using Simultaneous Biplanar Acquisition. J Arthroplasty 2017; 32:1670-1674. [PMID: 28087161 DOI: 10.1016/j.arth.2016.11.057] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 11/10/2016] [Accepted: 11/29/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Studies that have previously examined the relationship between acetabular component inclination angle and polyethylene wear have shown increased wear of conventional polyethylene with high inclination angles. To date, there are no long-term in vivo studies examining the correlation between cup position and polyethylene wear with highly crosslinked polyethylene. METHODS An institutional arthroplasty database was used to identify patients who had metal-on-highly crosslinked polyethylene primary total hip arthroplasty using the same component design with a minimum follow-up of 10 years. A modified radiostereometric analysis examination setup was utilized, recreating standard anteroposterior and cross-table lateral examinations in a single stereo radiostereometric analysis acquisition. The same radiographs were used to measure inclination angle and anteversion. RESULTS A total of 43 hips were included for analysis in this study. Average follow-up was 12.3 ± 1.2 years. The average linear wear rate was calculated to be 0.066 ± 0.066 mm/y. Inclination angle was not correlated with polyethylene wear rate (P = .82). Anteversion was also not correlated with polyethylene wear rate (P = .11). CONCLUSION At long-term follow-up of >10 years, highly crosslinked polyethylene has a very low wear rate. This excellent tribology is independent of acetabular position. The low wear rate highlights the excellent results of metal on highly crosslinked polyethylene, and supports its use in total hip arthroplasty.
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Affiliation(s)
- Prateek Goyal
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - James L Howard
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Xunhua Yuan
- Imaging Research Laboratories, Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Matthew G Teeter
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Surgical Innovation Program, Lawson Health Research Institute, London, ON, Canada
| | - Brent A Lanting
- Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
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