Retrieval analysis of two contemporary total knee designs: Influence of femoral component roughness and type of polyethylene

Comparative retrieval analysis of contemporary mobile and fixed unicompartmental knee bearing designs

There are two different concepts behind Unicompartmental Knee Replacement (UKR). Mobile bearings, as exemplified by the Oxford UKR, and fixed bearings, as exemplified by the Physica ZUK. These are the two most commonly implanted UKRs in the UK. For the first time, a comparison of the tribological features of 19 explanted Oxford and 19 explanted Physica ZUK UKRs was undertaken. Surface damage on the polyethylene (PE) inserts of the Oxford and Physica ZUK cohorts were assessed using an established semi-quantitative scoring method. The femoral components of both cohorts were assessed using a non-contact 3D profilometer to measure roughness values. It was found that the PE inserts of the Oxford cohort (22.54 ± 9.14) had statistically significant greater damage scores than the Physica ZUK cohort (16.50 ± 5.17) (p = 0.04). However, the femoral components of the Oxford cohort showed lower roughness values than the Physica ZUK cohort (p = 0.00). This is the first study that reports a comparative roughness analysis between retrieved Oxford and Physica ZUK UKR designs.

Explant analysis of a Maestro™ wrist prosthesis and calculation of its lubrication regime

Explant analysis can provide key insights to understanding failures of artificial joints and thus how they might be improved for the ultimate benefit of patients. There are no previous reports of explant analysis of an artificial wrist joint. In this study, an explanted metal-on-polymer Maestro wrist was analysed both in macro and nanoscales to estimate its biotribological performance. The articulation was formed between a cobalt chromium carpal head and an ultrahigh molecular weight polyethylene bearing. The surface roughness values of its articulating surfaces and the backside of the articulation were measured. On average, the articulating surface roughness values were calculated as 0.06 ± 0.02 μm and 1.29 ± 0.63 μm for the cobalt chromium carpal head and ultrahigh molecular weight polyethylene bearing, respectively. Both surfaces had negative skewness, indicating a preponderance of valleys. On the articulating surface of the carpal head, light scratches were observed, and no impingement was observed throughout the component. The polymeric surface had a polished appearance. It had unidirectional scratches at the centre of the articulation, pits of different sizes on its articulating surface, and matt white subsurface regions. The backside of the UHMWPE bearing and the convex surface of the radial body that it was sitting on, were found to have average surface roughness values of 4.23 ± 0.69 μm and 5.57 ± 1.05 μm, respectively. The difference in the means was not significant (p > 0.05). Taking the articulating surface roughness values, the lubrication regime that the explanted Maestro wrist operated under in vivo was estimated for varying physiological conditions, i.e. varying loads, entraining velocities and lubricant viscosities. In every case considered, the explant was found to operate under boundary lubrication.