Polyethylene wear in total hip and knee arthroplasties

Lewis, Gladius

doi:10.1002/(sici)1097-4636(199721)38:1<55::aid-jbm8>3.0.co;2-g

Cited by 131 publications

(64 citation statements)

References 39 publications

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“…Pitting is thought to be caused by two distinct methods. The first method has been traditionally thought to be a fatigue mechanism from cyclic loading [1,15,16], while the second is an abrasive mechanism where third body particles embed and dislodge in the articulating surfaces of the insert [16][17][18][19]. We microscopically observed embedded debris in approximately 15 % of the inserts.…”

Section: Discussionmentioning

confidence: 81%

Oxidative properties and surface damage mechanisms of remelted highly crosslinked polyethylenes in total knee arthroplasty

MacDonald

Higgs

Parvızı

et al. 2013

International Orthopaedics (SICOT)

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Purpose Remelted highly crosslinked polyethylenes (HXLPEs) were introduced in total knee replacement (TKR) starting in 2001 to reduce wear and particle-induced lysis. The purpose of this study was to investigate the damage mechanisms and oxidative stability of remelted HXLPEs used in TKR. Methods A total of 186 posteriorly stabilised tibial components were retrieved at consecutive revision operations. Sixty nine components were identified as remelted HXLPE. The conventional inserts were implanted for 3.4±2.7 years, while the remelted components were implanted 1.4 ± 1.2 years. Oxidation was assessed using Fourier transform infrared spectroscopy. Results Remelted HXLPE inserts exhibited lower oxidation indices compared to conventional inserts. We were able to detect slight regional differences within the HXLPE cohort, specifically at the bearing surface. Conclusion Remelted HXLPE was effective at reducing oxidation in comparison to gamma inert sterilised controls. Additional long-term HXLPE retrievals are necessary to ascertain the long term in vivo stability of these materials in TKR.

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Section: Discussionmentioning

confidence: 81%

Oxidative properties and surface damage mechanisms of remelted highly crosslinked polyethylenes in total knee arthroplasty

MacDonald

Higgs

Parvızı

et al. 2013

International Orthopaedics (SICOT)

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“…Stress-induced martensite is responsible for the superelastic behaviour exhibited by shape memory alloys. Their elastic recoverable strain can reach up to 10 per cent, while for elastic metallic materials it is Lewis (1997a), Phillips (2003) and Lewis (2006) anchoring of hip prostheses vertebroplasties and kyphoplasties polyethylene (PE) liner of acetabular cups in hip arthroplasties Fisher & Dowson (1991) and Lewis (1997b) tibial insert and patellar components in total knee arthroplasties (Continued. ) approximately 0.1 per cent.…”

Section: Metallic Materialsmentioning

confidence: 99%

Biomaterials in orthopaedics

Navarro

Michiardi

Castaño

et al. 2008

J. R. Soc. Interface.

1,289

730

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At present, strong requirements in orthopaedics are still to be met, both in bone and joint substitution and in the repair and regeneration of bone defects. In this framework, tremendous advances in the biomaterials field have been made in the last 50 years where materials intended for biomedical purposes have evolved through three different generations, namely first generation (bioinert materials), second generation (bioactive and biodegradable materials) and third generation (materials designed to stimulate specific responses at the molecular level). In this review, the evolution of different metals, ceramics and polymers most commonly used in orthopaedic applications is discussed, as well as the different approaches used to fulfil the challenges faced by this medical field.

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“…Revision rates of lumbar TDR, at 6-11.2% [5,6], are also comparable to fusion, at 5.8-22% [6,7] within 2 years. However, there are concerns that these articulating designs may be subject to long-term failure due to wear, which has been widely documented in total hip and knee arthroplasty [8]. There is a growing body of evidence that polyethylene wear debris has osteolytic potential in the spine, and specific cases of TDR-related osteolysis have now begun to emerge [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

The effect of anterior–posterior shear load on the wear of ProDisc-L TDR

et al. 2010

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The current wear-testing standard (ISO18192-1) for total disc replacement (TDR) requires only four degrees of freedom (DOF) inputs: axial load, flexionextension, lateral bending and axial rotation. The study aim was to assess the effect of an additional DOF, anterior-posterior (AP) shear on the wear of the ProDisc-L TDR. A 5DOF simulator was used to test ProDisc-L implants under 4DOF and 5DOF conditions. The 4DOF conditions were defined by ISO18192-1 whilst the 5DOF used ISO18192-1 conditions with the addition of an AP load of ?175 and -140 N (anterior and posterior, respectively), extrapolated from in vivo data. The implants were mounted such that the polyethylene insert could be removed for gravimetric measurements. Tests were run using bovine serum (15 g/l protein concentration) as a lubricant for five million cycles (MC), with measurements repeated every 1 MC. The mean wear rate in the 4DOF test was 12.7 ± 2.1 mg/MC compared to 11.6 ± 1.2 mg/MC in the 5DOF test. There were marked differences in the wear scars between 4DOF and 5DOF simulations. With 4DOF, wear scars were centralised on the dome of the insert, whilst 5DOF scars were larger, breaching the anterior rim of the dome causing deformation at the edge. The 4DOF wear test showed similar gravimetric wear rates to previously published ISO-tested TDRs. The addition of AP load was found to have no significant effect on the overall wear rate. However, there were pronounced differences in the respective wear scars, which highlights the need for more research in order to understand the factors that influence wear of TDR.

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Polyethylene wear in total hip and knee arthroplasties

Cited by 131 publications

References 39 publications

Oxidative properties and surface damage mechanisms of remelted highly crosslinked polyethylenes in total knee arthroplasty

Oxidative properties and surface damage mechanisms of remelted highly crosslinked polyethylenes in total knee arthroplasty

Biomaterials in orthopaedics

The effect of anterior–posterior shear load on the wear of ProDisc-L TDR

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