Wear Assessment of Tibial Inserts Made of Highly Cross-Linked Polyethylene Supplemented with Dodecyl Gallate in the Total Knee Arthroplasty

Zhang, Min; Wang, Jiayu; Su, Jian; Wang, Jianjun; Yan, Shi-Tong; Luan, Yichao; Cheng, Cheng‐Kung

doi:10.3390/polym13111847

Cited by 4 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A previous study from our research group reported that unaged HXLPE-DG knee inserts had a wear rate of 3.92 mg/million cycles [ 1 ], which was similar to the results of this study, although the earlier study did not consider the aged specimen. Haider et al reported UHMWPE tibial inserts with a wear rate of 19.88 mg/million cycles [ 15 ], which was more than four times that of HXLPE-DG.…”

Section: Discussionsupporting

confidence: 88%

“…The reason may be that the cross-linking process reduces the deformability of the polyethylene inserts, resulting in less fibrous particles [ 31 , 32 ], and larger polyethylene particles could be crushed under the action of cyclic stress. At the same time, the proportion of large strip-shaped, needle-shaped, and fibrous particles was greatly reduced [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Total knee arthroplasty (TKA) is considered an effective surgical treatment for knee osteoarthritis [ 1 , 2 ]. Highly cross-linked polyethylene (HXLPE) is increasingly used in total hip arthroplasty (THA) and is gradually replacing conventional ultrahigh-molecular-weight polyethylene (UHMWPE) as the material of choice for bearings due to its excellent wear resistance.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Wear Analysis of Tibial Inserts Made of Highly Cross-Linked Polyethylene Supplemented with Dodecyl Gallate before and after Accelerated Aging

Wang²,

Yan³

et al. 2022

Polymers

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Wear Analysis of Tibial Inserts Made of Highly Cross-Linked Polyethylene Supplemented with Dodecyl Gallate before and after Accelerated Aging

Wang²,

Yan³

et al. 2022

Polymers

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, recent studies have shown that a neutral alignment did not improve the clinical outcome or survival rate, and a tolerance of 3° varus to 3° valgus could not be considered a “safe zone” with modern personalized alignment strategies, especially for an updated prosthesis ( Tibbo et al, 2021 ; Schelker et al, 2022 ). A possible reason is considerable differences in the design of contemporary knee prostheses, which can affect the mechanical behavior and wear performance ( Asseln et al, 2021 ; Zhang et al, 2021 ; Su et al, 2022 ). Although advanced techniques, like personalized specific instrumentation, navigation systems, and robotic surgeries, have improved surgical precision and alignment accuracy, malalignment is still a common complication.…”

Section: Discussionmentioning

confidence: 99%

Mechanical alignment tolerance of a cruciate-retaining knee prosthesis under gait loading—A finite element analysis

Luan

Wang

Fang

et al. 2023

Front. Bioeng. Biotechnol.

Self Cite

View full text Add to dashboard Cite

Component alignment is one of the most crucial factors affecting total knee arthroplasty’s clinical outcome and survival. This study aimed to investigate how coronal, sagittal, and transverse malalignment affects the mechanical behavior of the tibial insert and to determine a suitable alignment tolerance on the coronal, sagittal, and transverse planes. A finite element model of a cruciate-retaining knee prosthesis was assembled with different joint alignments (−10°, −7°, −5°, −3°, 0°, 3°, 5°, 7°, 10°) to assess the effect of malalignment under gait loading. The results showed that varus or valgus, extension, internal rotation, and excessive external rotation malalignments increased the maximum Von Mises stress and contact pressure on the tibial insert. The mechanical alignment tolerance of the studied prosthesis on the coronal, sagittal, and transverse planes was 3° varus to 3° valgus, 0°–10° flexion, and 0°–5° external rotation, respectively. This study suggests that each prosthesis should include a tolerance range for the joint alignment angle on the three planes, which may be used during surgical planning.

show abstract

“…Total knee replacement (henceforth TKR) is successfully utilized to treat severely degenerated joints and is a standard procedure for treating osteoarthritic discomfort. A conventional TKR implant consists of a metallic femoral and a tibial element embedded into the femur and the tibia bone, respectively, and an insert (referred to as spacers) made of ultra-high molecular weight polyethylene (henceforth UHMWPE) (2) . Wear is a persistent problem in TKR because of its inconsistent and occasionally unstable form (2) , which may eventually cause aseptic loosening, osteolysis, periprosthetic issues (3) and premature failure (2,3) .…”

Section: Introductionmentioning

confidence: 99%

Effect of Cryogenic Treatment on Tribological and Surface Properties of 3D Printed Thermoplastic Polyurethane

Veer,

Vettivel,

Madan

et al. 2023

IJST

View full text Add to dashboard Cite

Objective: Investigating the effects of Deep Cryogenic Treatment (DCT) on the mass wear of 3D printed Thermoplastic Polyurethane (TPU) for application in knee spacers. Methods: Extrusion Temperature (ET), Print Speed (PS), Layer Thickness (LT), and Raster Orientation (RO), were the parameters used in this study. The mass wear of untreated and DCT TPU was obtained. The surface images were obtained through a Scanning Electron Microscope (SEM) and analyzed in the Gwyddion AFM software to investigate the surface texture, waviness, and roughness of the untreated and treated TPU. Findings: DCT decreased mass wear in 3D-printed TPU specimens. A higher ET (250 • C) yielded superior mass wear performance -conversely, higher PS elevated mass wear, with an optimal print speed of 15 mm/s. The most negligible mass wear was observed at 0.1 mm LT. The angle of RO exhibited significance with a 45 • /135 • RO orientation. Notably, PS demonstrated the most significant influence on mass wear for untreated TPU (61.11%), while for treated TPU, ET exerted the most substantial impact (90.61%). These insights were validated through analysis of variance (ANOVA) and regression modeling, indicating the robustness of the findings. Novelty: To date, injection-molded ultra-high molecular weight polyethylene (UHMWPE) is deployed for knee spacers. However, its rapid wear, time-consuming, and expensive fabrication techniques are a significant concern in total knee replacement surgeries. For the first time, this study combined 3D printing and deep cryogenic treatment to fabricate and characterize the tribological performance of biocompatible TPU for its potential application in knee spacers. This novel approach involved cryogenically treating the 3D-printed TPU wear specimens, which displayed superior wear performance to injection-molded UHMWPE. This affirmed the suitability of the combined 3D printing and cryogenic treatment for TPU as a potential alternative to the current methods and material for knee spacer https://www.indjst.org/ 3491

show abstract

Wear Assessment of Tibial Inserts Made of Highly Cross-Linked Polyethylene Supplemented with Dodecyl Gallate in the Total Knee Arthroplasty

Cited by 4 publications

References 26 publications

Wear Analysis of Tibial Inserts Made of Highly Cross-Linked Polyethylene Supplemented with Dodecyl Gallate before and after Accelerated Aging

Wear Analysis of Tibial Inserts Made of Highly Cross-Linked Polyethylene Supplemented with Dodecyl Gallate before and after Accelerated Aging

Mechanical alignment tolerance of a cruciate-retaining knee prosthesis under gait loading—A finite element analysis

Effect of Cryogenic Treatment on Tribological and Surface Properties of 3D Printed Thermoplastic Polyurethane

Contact Info

Product

Resources

About