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Slouf M, Gajdosova V, Dybal J, Sticha R, Fulin P, Pokorny D, Mateo J, Panisello JJ, Canales V, Medel F, Bistolfi A, Bracco P. European Database of Explanted UHMWPE Liners from Total Joint Replacements: Correlations among Polymer Modifications, Structure, Oxidation, Mechanical Properties and Lifetime In Vivo. Polymers (Basel) 2023; 15:polym15030568. [PMID: 36771869 PMCID: PMC9921464 DOI: 10.3390/polym15030568] [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: 11/29/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
This contribution lays the foundation for the European database of explanted UHMWPE liners from total joint replacements. Three EU countries (Czech Republic, Italy and Spain) have joined their datasets containing anonymized patient data (such as age and BMI), manufacturer data (such as information on UHMWPE crosslinking, thermal treatment and sterilization), orthopedic evaluation (such as total duration of the implant in vivo and reasons for its revision) and material characterization (such as oxidative degradation and micromechanical properties). The joined database contains more than 500 entries, exhibiting gradual growth, and it is beginning to show interesting trends, which are discussed in our contribution, including (i) strong correlations between UHMWPE oxidative degradation, degree of crystallinity and microhardness; (ii) statistically significant differences between UHMWPE liners with different types of sterilization; (iii) realistic correlations between the extent of oxidative degradation and the observed reasons for total joint replacement failures. Our final objective and task for the future is to continuously expand the database, involving researchers from other European countries, in order to create a robust tool that will contribute to the better understanding of structure-properties-performance relationships in the field of arthroplasty implants.
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Affiliation(s)
- Miroslav Slouf
- Institute of Macromolecular Chemistry of the Czech Academy of Sciences, 16206 Prague, Czech Republic
- Correspondence: (M.S.); (F.M.); (P.B.)
| | - Veronika Gajdosova
- Institute of Macromolecular Chemistry of the Czech Academy of Sciences, 16206 Prague, Czech Republic
| | - Jiri Dybal
- Institute of Macromolecular Chemistry of the Czech Academy of Sciences, 16206 Prague, Czech Republic
| | - Roman Sticha
- 1st Orthopedics Clinic of the 1st Faculty of Medicine of Charles University and Motol University Hospital, 15006 Prague, Czech Republic
| | - Petr Fulin
- 1st Orthopedics Clinic of the 1st Faculty of Medicine of Charles University and Motol University Hospital, 15006 Prague, Czech Republic
| | - David Pokorny
- 1st Orthopedics Clinic of the 1st Faculty of Medicine of Charles University and Motol University Hospital, 15006 Prague, Czech Republic
| | - Jesús Mateo
- Department of Orthopaedic Surgery and Traumatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Department of Surgery, Medicine School, University of Zaragoza, 50009 Zaragoza, Spain
| | - Juan José Panisello
- Department of Orthopaedic Surgery and Traumatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Department of Surgery, Medicine School, University of Zaragoza, 50009 Zaragoza, Spain
| | - Vicente Canales
- Department of Orthopaedic Surgery and Traumatology, Royo Villanova Hospital, 50015 Zaragoza, Spain
| | - Francisco Medel
- Department of Mechanical Engineering-Institute of Engineering Research of Aragon, University of Zaragoza, 50018 Zaragoza, Spain
- Correspondence: (M.S.); (F.M.); (P.B.)
| | - Alessandro Bistolfi
- Department of Surgery, Orthopedics and Traumatology, Cardinal Massaia Hospital, 14100 Asti, Italy
| | - Pierangiola Bracco
- Chemistry Department and NIS Centre, University of Torino, 10125 Torino, Italy
- Correspondence: (M.S.); (F.M.); (P.B.)
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Meijering D, Duijn RGA, Murgia A, Boerboom AL, Eygendaal D, van den Bekerom MPJ, Bulstra SK, Stevens M, Vegter RJK. Elbow joint biomechanics during ADL focusing on total elbow arthroplasty - a scoping review. BMC Musculoskelet Disord 2023; 24:42. [PMID: 36653765 PMCID: PMC9847152 DOI: 10.1186/s12891-023-06149-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Overloading is hypothesized to be one of the failure mechanisms following total elbow arthroplasty (TEA). It is unclear whether the current post-operative loading instruction is compliant with reported failure mechanisms. Aim is therefore to evaluate the elbow joint load during activities of daily living (ADL) and compare these loads with reported failure limits from retrieval and finite element studies. METHODS A scoping review of studies until 23 November 2021 investigating elbow joint load during ADL were identified by searching PubMed/Medline and Web of Science. Studies were eligible when: (1) reporting on the elbow joint load in native elbows or elbows with an elbow arthroplasty in adults; (2) full-text article was available. RESULTS Twenty-eight studies with a total of 256 participants were included. Methodological quality was low in 3, moderate in 22 and high in 3 studies. Studies were categorized as 1) close to the body and 2) further away from the body. Tasks were then subdivided into: 1) cyclic flexion/extension, 2) push-up, 3) reaching, 4) self-care, 5) work. Mean flexion-extension joint load was 17 Nm, mean varus-valgus joint load 9 Nm, mean pronation-supination joint load 8 Nm and mean bone-on-bone contact force 337 N. CONCLUSION The results of our scoping review give a first overview of the current knowledge on elbow joint loads during ADL. Surprisingly, the current literature is not sufficient to formulate a postoperative instruction for elbow joint loading, which is compliant with failure limits of the prosthesis. In addition, our current instruction does not appear to be evidence-based. Our recommendations offer a starting point to assist clinicians in providing informed decisions about post-operative instructions for their patients.
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Affiliation(s)
- Daniëlle Meijering
- grid.4494.d0000 0000 9558 4598Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roos GA Duijn
- grid.4494.d0000 0000 9558 4598Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alessio Murgia
- grid.4494.d0000 0000 9558 4598Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alexander L. Boerboom
- grid.4494.d0000 0000 9558 4598Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Denise Eygendaal
- grid.5645.2000000040459992XDepartment of Orthopedics and Sports Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Michel PJ van den Bekerom
- grid.440209.b0000 0004 0501 8269Department of Orthopedic Surgery, OLVG, Amsterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Sjoerd K. Bulstra
- grid.4494.d0000 0000 9558 4598Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martin Stevens
- grid.4494.d0000 0000 9558 4598Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Riemer JK Vegter
- grid.4494.d0000 0000 9558 4598Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Wahed SB, Dunstan CR, Boughton PA, Ruys AJ, Faisal SN, Wahed TB, Salahuddin B, Cheng X, Zhou Y, Wang CH, Islam MS, Aziz S. Functional Ultra-High Molecular Weight Polyethylene Composites for Ligament Reconstructions and Their Targeted Applications in the Restoration of the Anterior Cruciate Ligament. Polymers (Basel) 2022; 14:polym14112189. [PMID: 35683861 PMCID: PMC9182730 DOI: 10.3390/polym14112189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
The selection of biomaterials as biomedical implants is a significant challenge. Ultra-high molecular weight polyethylene (UHMWPE) and composites of such kind have been extensively used in medical implants, notably in the bearings of the hip, knee, and other joint prostheses, owing to its biocompatibility and high wear resistance. For the Anterior Cruciate Ligament (ACL) graft, synthetic UHMWPE is an ideal candidate due to its biocompatibility and extremely high tensile strength. However, significant problems are observed in UHMWPE based implants, such as wear debris and oxidative degradation. To resolve the issue of wear and to enhance the life of UHMWPE as an implant, in recent years, this field has witnessed numerous innovative methodologies such as biofunctionalization or high temperature melting of UHMWPE to enhance its toughness and strength. The surface functionalization/modification/treatment of UHMWPE is very challenging as it requires optimizing many variables, such as surface tension and wettability, active functional groups on the surface, irradiation, and protein immobilization to successfully improve the mechanical properties of UHMWPE and reduce or eliminate the wear or osteolysis of the UHMWPE implant. Despite these difficulties, several surface roughening, functionalization, and irradiation processing technologies have been developed and applied in the recent past. The basic research and direct industrial applications of such material improvement technology are very significant, as evidenced by the significant number of published papers and patents. However, the available literature on research methodology and techniques related to material property enhancement and protection from wear of UHMWPE is disseminated, and there is a lack of a comprehensive source for the research community to access information on the subject matter. Here we provide an overview of recent developments and core challenges in the surface modification/functionalization/irradiation of UHMWPE and apply these findings to the case study of UHMWPE for ACL repair.
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Affiliation(s)
- Sonia B. Wahed
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
- Correspondence: (S.B.W.); (S.A.)
| | - Colin R. Dunstan
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
| | - Philip A. Boughton
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
| | - Andrew J. Ruys
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
| | - Shaikh N. Faisal
- ARC Centre of Excellence for Electromaterials Science & Intelligent Polymer Research Institute, Australian Institute of Innovative Materials, University of Wollongong, Wollongong, NSW 2522, Australia;
| | - Tania B. Wahed
- Department of Pharmacy, Jahangirnagar University, Savar 1342, Bangladesh;
| | - Bidita Salahuddin
- School of Chemical Engineering, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Xinying Cheng
- School of Biomedical Engineering, University of Sydney, Sydney, NSW 2006, Australia; (C.R.D.); (P.A.B.); (A.J.R.); (X.C.)
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW 2052, Australia; (Y.Z.); (C.H.W.); (M.S.I.)
| | - Yang Zhou
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW 2052, Australia; (Y.Z.); (C.H.W.); (M.S.I.)
| | - Chun H. Wang
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW 2052, Australia; (Y.Z.); (C.H.W.); (M.S.I.)
| | - Mohammad S. Islam
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW 2052, Australia; (Y.Z.); (C.H.W.); (M.S.I.)
| | - Shazed Aziz
- School of Chemical Engineering, The University of Queensland, Brisbane, QLD 4072, Australia;
- Correspondence: (S.B.W.); (S.A.)
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Meng Y, Xu J, Ma L, Jin Z, Prakash B, Ma T, Wang W. A review of advances in tribology in 2020–2021. FRICTION 2022; 10:1443-1595. [PMCID: PMC9552739 DOI: 10.1007/s40544-022-0685-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 07/22/2023]
Abstract
Around 1,000 peer-reviewed papers were selected from 3,450 articles published during 2020–2021, and reviewed as the representative advances in tribology research worldwide. The survey highlights the development in lubrication, wear and surface engineering, biotribology, high temperature tribology, and computational tribology, providing a show window of the achievements of recent fundamental and application researches in the field of tribology.
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Affiliation(s)
- Yonggang Meng
- State Key Laboratory of Tribology in Advanced Equipment, Tsinghua University, Beijing, 100084 China
| | - Jun Xu
- State Key Laboratory of Tribology in Advanced Equipment, Tsinghua University, Beijing, 100084 China
| | - Liran Ma
- State Key Laboratory of Tribology in Advanced Equipment, Tsinghua University, Beijing, 100084 China
| | - Zhongmin Jin
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031 China
- School of Mechanical Engineering, University of Leeds, Leeds, LS2 9JT UK
| | - Braham Prakash
- State Key Laboratory of Tribology in Advanced Equipment, Tsinghua University, Beijing, 100084 China
| | - Tianbao Ma
- State Key Laboratory of Tribology in Advanced Equipment, Tsinghua University, Beijing, 100084 China
| | - Wenzhong Wang
- School of Mechanical and Vehicle Engineering, Beijing Institute of Technology, Beijing, 100082 China
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