Polyethylene wear in unicondylar knee prostheses

Blunn, Gordon; Joshi, Atul; Lilley, Peter A.; Engelbrecht, E; Ryd, Leif; Lidgren, Lars; Hardinge, K.; Nieder, E; Walker, Peter S.

doi:10.3109/17453679209154776

Cited by 96 publications

(18 citation statements)

References 19 publications

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“…However, the process of polymer adherence is still unclear. Blunn et al [65] and Saiko of such kinematic conditions including various slip ratios is currently being investigated by the present authors at [78] showed that high subsurface strains of the polymer …”

Section: Wear Mechanisms and Processesmentioning

confidence: 97%

“…It has been suggested that a condition when the contact point on the polymer the kinematic condition at the bearing surfaces is the remaines stationary as the contact point on the metallic most dominant factor affecting the wear of polyethylene surface oscillates. Rolling is a condition when the relative and subsequently determines the type of wear process contact point velocity of both the metal and the polymer present [65]. It is difficult to quantify the kinematic are equivalent.…”

Section: Quality Of Uhmwpementioning

confidence: 99%

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Wear of ultra-high molecular weight polyethylene (UHMWPE) in total knee prostheses: A review of key influences

McGloughlin

Kavanagh

2000

Proc Inst Mech Eng H

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Abstract:The formation and development of wear is now widely accepted as one of the major concerns in the long-term survivorship of contemporary knee prostheses in vivo. This review examines the role of surface topography, third-body debris, load, contact mechanics and material quality in the wear process. Some of the kinematic and physiological issues that need to be modelled in the development of wear testing regimes for evaluation of material combinations and geometrical combinations in total knee implant designs are considered. Wear testing procedures and some of the results from wear tests are discussed and the need to consider the impact of rolling and sliding in the study of wear in total knee components is highlighted. The dominant wear mechanisms that occur in vivo are identified and the role of these mechanisms is currently being examined experimentally at the University of Limerick wear testing machine.Keywords: polymer wear debris (PWD), total joint replacement ( TJR), total knee replacement ( TKR), third body debris ( TBD) INTRODUCTIONtions in the surrounding tissues, causing macrophage activity and necrosis of the bone-prosthesis interface [14][15][16][17][18][19]. The biological response to loose PWD, is believed Over the last 30 years, ultra-high molecular weight polyto be a contributing factor to prosthetic loosening in TKRs. ethylene ( UHMWPE) has been the choice of material usedIn laboratory wear studies, it is important to know what as bearing surfaces in total joint replacements (TJRs). It is conditions can cause an increase in the wear rate of polyrenowned for its toughness, low friction and biocompatiethylene and hence an increase in the number of polymer bility [1][2][3]. Designs of total knee implants have a variety particles. Polyethylene wear has been related directly to its of contact geometries. Many now have relatively high conmolecular properties, and factors have been identified that formity whereby the radii of the curvature of both femoral affect the molecular characteristics of polyethylene and and tibial components are similar. A considerable number thereby its wear characteristics. [4][5][6][7][8][9][10][11][12][13]. The influence of surgical techniques on the these factors in more detail. long-term performance of TKRs has been well documented and will be discussed later. In vivo the generation of submicron-sized PWD can cause adverse cellular reac-2 IN VITRO STUDIES OF WEAR

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Section: Wear Mechanisms and Processesmentioning

confidence: 97%

Section: Quality Of Uhmwpementioning

confidence: 99%

Wear of ultra-high molecular weight polyethylene (UHMWPE) in total knee prostheses: A review of key influences

McGloughlin

Kavanagh

2000

Proc Inst Mech Eng H

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“…1986, Buechel et al 1991, and articular surface irregularities (Milliano andWhiteside 1991, Elbert et al 1992). Intergranular defects and variations in the crystallinity of the superficial 1-2 mm of the surface increase in vivo and in vitro wear (Elbert et al 1988, Blunn et al 1991, Finlay et al 1991, Wemer et al 1991, Blunn et al 1992, Jensen et al 1992, Li et al 1992. The manufacturing process, for example, heat treatment of the articular surface, heat molding (Bartel et al 1986), gamma irradiation (Rose et al 1979), etc.…”

Section: Causes Of Polyethylene Wearmentioning

confidence: 99%

“…may adversely affect the resistance to wear. One of the studies in this issue (Blunn et al 1992) indicates that conventionally machined high density polyethylene (HDPE) components are substantially different in homogenicity and porosity because of inadequate pressing or molding techniques (Blunn et al 1992). Inhomogenicity and porosity will inevitably result in increased wear and stress.…”

Section: Causes Of Polyethylene Wearmentioning

confidence: 99%

“…In this issue of Acta Orthopaedica Scandinavica four articles (Blunn et al 1992, Tulp 1992) focus on wear as a mechanism for unexpected prosthetic failure. The lifespan of knee prostheses has increased during two decades of improvements in choice of patients, implant design, surgical methods including guide instruments, soft tissue balancing, and better cementing techniques.…”

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confidence: 99%

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Polyethylene wear in knee arthroplasty

Goodman

Lidgren

1992

Acta Orthopaedica Scandinavica

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Wear testing of materials and surfaces for total knee replacement

Walker

Blunn

Lilley

1996

J. Biomed. Mater. Res.

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112

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A simple wear test was investigated for evaluating the wear and damage of material pairs when used in total knee replacement. The test consisted of an axially loaded metallic femoral indentor and a reciprocating ultrahigh molecular weight polyethylene (UHMWPE) flat disk that represented the tibial component. A number of variables were studied including the effect of conformity by varying the radii of the femoral surface, distilled water or serum as a lubricant, different femoral materials, and different types of UHMWPE. In general, the different morphologies of the surface wear of the UHMWPE were similar to those seen on retrieved total knee replacements. Increased conformity with a cylindrical indentor gave a reduced wear rate initially, compared with that of the lower conformity spherical indentor. However, the wear rates were similar subsequent to this initial wearing in phase. Transfer films of UHMWPE were observed on the cobalt-chrome indentors for both serum and distilled water lubrication, although this film was more extensive for distilled water. The lowest wear rate was observed when oxidized zirconium was used on the femoral side, which was attributed to greater wettability, surface hardness, and immunity to oxidative wear. Tests using cobalt-chrome femoral cylinders and different grades of UHMWPE showed different wear rates. Of these PEs, GUR 415 showed less wear than both RCH 1000 and UHMWPE containing numerous fusion defects. For the latter, wear was attributed to a fatigue mechanism, although in most cases it was associated with surface phenomena rather than subsurface cracking. However, in some specimens of UHMWPE subsurface crack propagations occurred with defects. The test method is discussed in relation to its applicability to the evaluation and comparison of bearing materials and surfaces, with particular application to total knee replacements.

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Polyethylene wear in unicondylar knee prostheses

Cited by 96 publications

References 19 publications

Wear of ultra-high molecular weight polyethylene (UHMWPE) in total knee prostheses: A review of key influences

Wear of ultra-high molecular weight polyethylene (UHMWPE) in total knee prostheses: A review of key influences

Polyethylene wear in knee arthroplasty

Wear testing of materials and surfaces for total knee replacement

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