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Su J, Wang J, Yan S, Zhang M, Zhang N, Luan Y, Cheng CK. Wear Analysis of Tibial Inserts Made of Highly Cross-Linked Polyethylene Supplemented with Dodecyl Gallate before and after Accelerated Aging. Polymers (Basel) 2022; 14:polym14235281. [PMID: 36501675 PMCID: PMC9737456 DOI: 10.3390/polym14235281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
The wear of the tibial insert is one of the primary factors leading to the failure of total knee arthroplasty. As materials age, their wear performance often degrades. Supplementing highly cross-linked polyethylene (HXLPE) with dodecyl gallate (DG) can improve the oxidation stability of tibial inserts for use in total knee arthroplasty (TKA). This study aimed to evaluate the wear resistance of HXLPE supplemented with DG (HXLPE-DG) tibial inserts before and after accelerated aging. HXLPE-DG tibial inserts were subjected to wear testing of up to 5 million loading cycles according to ISO 14243, and the resulting wear particles were analyzed according to ISO 17853. The wear rate, number, size, and shape of the wear particles were analyzed. The average wear rate of the unaged samples was 4.39 ± 0.75 mg/million cycles and was 3.22 ± 1.49 mg/million cycles for the aged samples. The unaged tibial inserts generated about 2.80 × 107 particles/mL following the wear test, but this was considerably lower for the aged samples at about 1.35 × 107 particles/mL. The average equivalent circle diameter (ECD) of the wear particles from the unaged samples was 0.13 μm (max: 0.80 μm; min: 0.04 μm), and it was 0.14 μm (max: 0.66 μm; min: 0.06 μm) from the aged samples. Moreover, 22.1% of the wear particles from the unaged samples had an aspect ratio (AR) of >4 (slender shape), while this was 15.4% for the aged samples. HXLPE-DG improves the wear performance of the material over time. HXLPE-DG is a novel material that has been demonstrated to have antiaging properties and high wear resistance, making it a promising candidate for use in TKA. Nevertheless, the results are preliminary and will be clarified in further studies.
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Affiliation(s)
- Jian Su
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
- Beijing Institute of Medical Device Testing, Beijing 101111, China
| | - Jianjun Wang
- Beijing Institute of Medical Device Testing, Beijing 101111, China
| | - Shitong Yan
- Beijing Institute of Medical Device Testing, Beijing 101111, China
| | - Min Zhang
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Ningze Zhang
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Yichao Luan
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Cheng-Kung Cheng
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
- Correspondence:
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Huang CH, Lu YC, Hsu LI, Liau JJ, Chang TK, Huang CH. Effect of material selection on tibial post stresses in posterior-stabilized knee prosthesis. Bone Joint Res 2020; 9:768-777. [PMID: 33135462 PMCID: PMC7649505 DOI: 10.1302/2046-3758.911.bjr-2020-0019.r2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aims The material and design of knee components can have a considerable effect on the contact characteristics of the tibial post. This study aimed to analyze the stress distribution on the tibial post when using different grades of polyethylene for the tibial inserts. In addition, the contact properties of fixed-bearing and mobile-bearing inserts were evaluated. Methods Three different grades of polyethylene were compared in this study; conventional ultra high molecular weight polyethylene (UHMWPE), highly cross-linked polyethylene (HXLPE), and vitamin E-stabilized polyethylene (VEPE). In addition, tibial baseplates with a fixed-bearing and a mobile-bearing insert were evaluated to understand differences in the contact properties. The inserts were implanted in neutral alignment and with a 10° internal malrotation. The contact stress, von Mises stress, and equivalent plastic strain (PEEQ) on the tibial posts were extracted for comparison. Results The stress and strain on the tibial post for the three polyethylenes greatly increased when the insert was placed in malrotation, showing a 38% to 56% increase in von Mises stress and a 335% to 434% increase in PEEQ. The VEPE insert had the lowest PEEQ among the three materials. The mobile-bearing design exhibited a lower increase in stress and strain around the tibial posts than the fixed-bearing design. Conclusion Using VEPE for the tibial component potentially eliminates the risk of material permanent deformation. The mobile-bearing insert can help to avoid a dramatic increase in plastic strain around the tibial post in cases of malrotation. The mobility allows the pressure to be distributed on the tibial post and demonstrated lower stresses with all three polyethylenes simulated. Cite this article: Bone Joint Res 2020;9(11):768–777.
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Affiliation(s)
- Chang-Hung Huang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,School of Dentistry, National Yang-Ming University, Taipei, Taiwan.,Institute of Geriatric Welfare Technology and Science, MacKay Medical College, New Taipei City, Taiwan
| | - Yung-Chang Lu
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Department of Orthopaedic Surgery, MacKay Memorial Hospital, Taipei, Taiwan
| | - Lin-I Hsu
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
| | - Jiann-Jong Liau
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Ting-Kuo Chang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Department of Orthopaedic Surgery, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chun-Hsiung Huang
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Department of Orthopaedic Surgery, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Orthopaedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
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Zhang X, Shi G, Sun X, Zheng W, Lin X, Chen G. Factors Influencing the Outcomes of Artificial Hip Replacements. Cells Tissues Organs 2019; 206:254-262. [DOI: 10.1159/000500518] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/16/2019] [Indexed: 11/19/2022] Open
Abstract
Hip replacement is one of the most successful surgeries in the clinic for the removal of painful joints. Hip osteoarthritis and femoral head necrosis are the 2 main reasons for hip replacement. Several factors are associated with the outcomes of surgery. Nonsurgical factors include gender, age, body mass index, prosthetic material, and risk factors. Surgical factors are anesthesia, postoperative complications, and rehabilitation. Considering the increasing demand for hip arthroplasty and the rise in the number of revision operations, it is imperative to understand factor-related progress and how modifications of these factors promotes recovery following hip replacement. In this review, we first summarize recent findings regarding crucial factors that influence the outcomes of artificial hip replacement surgery. These findings not only show the time-specific effect for the treatment and recovery from hip arthroplasty in the clinic, but also provide suitable choices for different individuals for clinicians to consider. This, in turn, will help to develop the best possible postoperative program for specific patients.
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