Profilometry Analysis and Improvements of a Novel Damage Scoring Method for Metal Bearing Surfaces of Shoulder Replacements

2012 ◽  
Author(s):  
Farzana Ansari ◽  
Eli W. Patten ◽  
Cynthia Cruz ◽  
Erin Beitel ◽  
Amelia Swan ◽  
...  
Keyword(s):  
Surface Damage ◽  
Implant Loosening ◽  
Scoring Method ◽  
Joint Replacements ◽  
Total Joint Replacements ◽  
Uhmwpe Wear ◽  
Ultra High Molecular Weight ◽  
Cobalt Chrome

Characterizing the type and extent of in vivo damage to total joint replacements (TJR) is important for improving the success of arthroplasty outcomes, modeling damage modalities, and validating simulator studies. A method for quantifying the damage present on Cobalt Chrome (CoCr) humeral heads was developed in our lab to fulfill a much-needed gap in clinical knowledge regarding total shoulder replacements as well as metallic bearing surfaces [1,2]. A lack of inter-observer consistency with regard to severity classifications from our initial protocol [1] prompted several modifications to the method, which are tested and described here in this study. Also, since sub-micron scale ultra-high molecular weight polyethylene (UHMWPE) wear debris is linked to osteolysis and implant loosening, additional analysis with high magnification 3D optical profilometry was performed on a subset of damage modes with a long-term goal of correlating surface damage with propensity for osteolysis in TJR [3,4].

Macro- and Microscale Analysis of Bearing Surface Damage on Total Shoulder Replacements

2013 ◽  
Author(s):  
Farzana Ansari ◽  
Jeff Koller ◽  
Amelia Swan ◽  
Sunny Kung ◽  
Stephen B. Gunther ◽  
...  
Keyword(s):  
Surface Damage ◽  
Bearing Surface ◽  
Joint Replacements ◽  
Total Joint Replacements ◽  
Total Knee Replacements ◽  
Uhmwpe Wear ◽  
Hip Replacements ◽  
Clinical Consequences ◽  
Bearing Damage

Damage to bearing surfaces of total joint replacements (TJR) can have clinical consequences: wear debris generated from ultra-high molecular weight polyethylene (UHMWPE) surfaces can cause osteolysis and subsequent implant loosening [1]. Counterbearing metallic damage may significantly increase UHMWPE wear [2]. Documenting the morphology, frequency and location of bearing surface damage may provide insight into wear initiation and prevention. While scoring methodologies have been available and validated for total hip replacements (THR) and total knee replacements (TKR) [3–4], there is a paucity of validated scoring protocols for total shoulder replacements (TSR) [5]. Our previous work presented a damage scoring methodology to evaluate the severity and coverage of six damage modes on retrieved cobalt chrome (CoCr) humeral heads [6]. In this study, we adapt that protocol to include bearing surface damage on the counter-bearings (UHMWPE glenoid components). Additionally, we incorporate the results of 3D profilometry analysis of scratches in the Co-Cr humeral heads [6]. Ultimately, this macroscale and microscale analysis, combined with clinical data, for coupled TSR retrievals will provide insight on the origin, evolution and consequences of bearing damage in vivo.

scholarly journals Development and Validation of the Small Punch Test for UHMWPE Used in Total Joint Replacements

2000 ◽  
Author(s):  
A. A. Edidin ◽  
S. M. Kurtz
Keyword(s):  
The United States ◽  
Joint Arthroplasty ◽  
Small Punch Test ◽  
Joint Function ◽  
Joint Replacements ◽  
Total Joint Replacements ◽  
Punch Test ◽  
The 1960S ◽  
Development And Validation ◽  
Ultra High Molecular Weight

Abstract Around 500,000 total hip and knee arthroplasties are performed each year in the United States, with a comparable number performed annually throughout the rest of the world. Since its development in the 1960s, contemporary total joint arthroplasty has proven to be extremely successful in alleviating pain and restoring joint function. However, for a minority of patients, mechanical and biological sequelae emanating from the breakdown of the ultra-high molecular weight polyethylene (UHMPWE) bearings limit the longevity of the procedures.

Designing for Crosslinked UHMWPE Implants: Clinical Consequences of Stress Concentrations

2013 ◽  
Author(s):  
Farzana Ansari ◽  
Eli Patten ◽  
Jennifer Chang ◽  
Suzanne Chou ◽  
Amir Mehdizadeh ◽  
...  
Keyword(s):  
Ultrahigh Molecular Weight Polyethylene ◽  
Joint Space ◽  
Stress Concentrations ◽  
Total Joint Replacements ◽  
Uhmwpe Wear ◽  
Clinical Consequences ◽  
Radiation Processes ◽  
The Cost ◽  
Term Performance

Ultrahigh molecular weight polyethylene (UHMWPE) remains the polymer bearing of choice for total joint replacements (TJR) [1]. However, the long-term performance of this polymer has been limited by in vivo wear: UHMWPE wear debris generated in the joint space can travel into the periprosthetic bone, initiating osteolysis and implant loosening [2]. Crosslinked UHMWPE (through ionizing radiation) has demonstrated increased wear resistance [3], but at the cost of reduced fatigue crack propagation and fracture resistance [4]. Additionally, radiation processes can release free radicals which, when not eliminated through thermal treatment, can increase UHMWPE susceptibility to oxidation and mechanical embrittlement [5]. Such tradeoffs present clinical concerns when implant designs incorporate stress concentrations that experience elevated stresses under loading. These compromises are evaluated through the failure analysis of several crosslinked UHMWPE retrievals that fractured in vivo.

Ultra-High Molecular Weight Polyethylene Wear Debris Generated in Vivo and in Laboratory Tests; the Influence of Counterface Roughness

1996 ◽  
Vol 210 (1) ◽  
pp. 3-10 ◽  
Author(s):  
J L Hailey ◽  
E Ingham ◽  
M Stone ◽  
B M Wroblewski ◽  
J Fisher
Keyword(s):  
Molecular Weight ◽  
High Molecular Weight ◽  
Wear Debris ◽  
Laboratory Tests ◽  
Polyethylene Wear ◽  
Uhmwpe Wear ◽  
Major Variable ◽  
Ultra High Molecular Weight ◽  
Counterface Roughness

The objective of this study was to investigate the effect of counterface roughness and lubricant on the morphology of ultra-high molecular weight polyethylene (UHMWPE) wear debris generated in laboratory wear tests, and to compare this with debris isolated from explanted tissue. Laboratory tests used UHMWPE pins sliding against stainless steel counterfaces. Both water and serum lubricants were used in conjunction with rough and smooth counterfaces. The lubricants and tissue from revision hip surgery were processed to digest the proteins and permit filtration. This involved denaturing the proteins with potassium hydroxide (KOH), sedimentation of any remaining proteins, and further digestion of these proteins with chromic acid. All fractions were then passed through a 0.2 μm membrane, and the debris examined using scanning electron microscopy. The laboratory studies showed that the major variable influencing debris morphology was counterface roughness. The rougher counter-faces produced larger numbers of smaller particles, with a size range extending below 1 μm. For smooth counterfaces there were fewer of these small particles, and evidence of larger platelets, greater than 10 μm in diameter. Analysis of the debris from explanted tissues showed a wide variation in the particle size distribution, ranging from below 1 μm up to several millimetres in size. Of major clinical significance in relation to osteolysis and loosening is roughening of the femoral components, which may lead to greater numbers of the sub-micron-sized particles.

Load Scenarios Influence Fluid Absorption of Polyethylene

2005 ◽  
Author(s):  
T. Schwenke ◽  
C. Rieker ◽  
M. A. Wimmer
Keyword(s):  
Wear Testing ◽  
Fluid Absorption ◽  
Joint Replacements ◽  
Wear Rates ◽  
Total Joint Replacements ◽  
Fluid Uptake ◽  
Dynamically Loaded ◽  
Low Wear ◽  
Lubrication Conditions

Wear of total joint replacements is determined gravimetrically in simulator studies. A mix of bovine serum, distilled water, and additives is intended to replicate the lubrication conditions in-vivo. Weight gain due to fluid absorption during testing of UHMWPE components is corrected using a load soak station. In this study six sets of UHMWPE pins were tested for their fluid soak behavior. The samples were subjected to three different loading scenarios while being submersed in two types of commonly used lubricants. After two million cycles or 23.1 days, respectively, the different fluids lead to significantly different soaking results. Test groups that were dynamically loaded gained more weight than unloaded or statically loaded samples. The results suggest that dynamically loaded soak control stations are required during wear testing of UHMWPE components. Otherwise the fluid uptake masks the wear measurement, especially for new polyethylene materials with low wear rates. Furthermore, an agreement on detailed lubricant specifications is desirable.

A General Adhesive Wear Simulation for Total Joint Replacements: Application to the Patellofemoral Joint

2001 ◽  
Author(s):  
Anthony J. Petrella ◽  
Mark C. Miller
Keyword(s):  
Patellofemoral Joint ◽  
Adhesive Wear ◽  
Total Joint Replacement ◽  
Wear Testing ◽  
Wear Simulation ◽  
Joint Replacements ◽  
Total Joint Replacements ◽  
Routine Basis ◽  
Total Knee ◽  
Ultra High Molecular Weight

Abstract Advances in design, materials, and fixation have increased the longevity of total joint replacements and significantly reduced the incidence of mechanical failure or loosening of implant components. Wear of the ultra-high molecular weight polyethylene (UHMWPE) bearing material used in most implants is now among the most important problems in total joint replacement. Wear tests in joint simulators are the gold standard for evaluation of wear resistance and are performed on a routine basis in many research laboratories. Physical wear testing, however, is labor intensive and time consuming. Numerical wear simulations have been developed and applied to the hip joint to evaluate adhesive wear of polyethylene liners [1,2]. The purpose of this project was to develop a general adhesive wear simulation applicable to any articulating joint with arbitrary geometry and subject to arbitrary relative motion. Validation of the model was established through application to the patellofemoral joint of a total knee replacement.

The yielding, plastic flow, and fracture behavior of ultra-high molecular weight polyethylene used in total joint replacements

Biomaterials ◽  
1998 ◽  
Vol 19 (21) ◽  
pp. 1989-2003 ◽  
Author(s):  
Steven M. Kurtz ◽  
Lisa Pruitt ◽  
Charles W. Jewett ◽  
R. Paul Crawford ◽  
Deborah J. Crane ◽  
...  
Keyword(s):  
Molecular Weight ◽  
High Molecular Weight ◽  
Plastic Flow ◽  
Fracture Behavior ◽  
Joint Replacements ◽  
Total Joint Replacements ◽  
Ultra High Molecular Weight

Medium- and long-term outcomes for hand and wrist pyrocarbon implants

2019 ◽  
Vol 44 (9) ◽  
pp. 887-897 ◽  
Author(s):  
Philippe Bellemère
Keyword(s):  
Minimally Invasive ◽  
Functional Recovery ◽  
Soft Tissues ◽  
Silicone Implants ◽  
Long Term Outcomes ◽  
Joint Replacements ◽  
Total Joint Replacements ◽  
Active Patients ◽  
Wrist Joints

The article reviews the techniques and surgical outcomes of arthroplasties of the metacarpophalangeal, carpometacarpal and the wrist joints. In my patients, interposition pyrocarbon implants quickly achieve functional recovery and do not deteriorate time. Bony and articular tolerances are remarkable. These implants are a valid alternative to conventional arthroplasties, such as trapeziectomies, silicone implants and total joint replacements. Because of the implant’s small size, the surgery can be done through minimally invasive approaches especially for young and active patients. A technical key is to properly manage the bone surfaces of the joint and the peri-articular soft tissues to avoid early implant instability.

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