Wear debris, of deferent sizes, shapes and quantities, generated in artificial hip and knees is largely confined to the bone and joint interface. This debris interacts with periprosthetic tissue and may cause aseptic loosening. The purpose of this review is to summarize and collate findings of the recent demonstrations on debris characterization and their biological response that influences the occurrence in implant migration. A systematic review of peer-reviewed literature is performed, based on inclusion and exclusion criteria addressing mainly debris isolation, characterization, and biologic responses. Results show that debris characterization largely depends on their appropriate and accurate isolation protocol. The particles are found to be non-uniform in size and non-homogeneously distributed into the periprosthetic tissues. In addition, the sizes, shapes, and volumes of the particles are influenced by the types of joints, bearing geometry, material combination, and lubricant. Phagocytosis of wear debris is size dependent; high doses of submicron-sized particles induce significant level of secretion of bone resorbing factors. However, articles on wear debris from engineered surfaces (patterned and coated) are lacking. The findings suggest considering debris morphology as an important parameter to evaluate joint simulator and newly developed implant materials.
Coatings such as diamond-like carbon (DLC) and titanium nitride (TiN) are employed in joint implants due to their excellent tribological properties. Recently, graphite-like carbon (GLC) and tantalum (Ta) have been proven to have good potential as coating as they possess mechanical properties similar to bones—high hardness and high flexibility. The purpose of this systematic literature review is to summarize the coating techniques of these four materials in order to compare their mechanical properties and tribological outcomes. Eighteen studies published between January 2000 and February 2013 have met the inclusion criteria for this review. Details of their fabrication parameters, material and mechanical properties along with the tribological outcomes, such as friction and wear rate, were identified and are presented in a systematic way. Although experiment conditions varied, we conclude that Ta has the lowest wear rate compared to DLC, GLC and TiN because it has a lower wear rate with high contact pressure as well as higher hardness to elasticity ratio. However, a further tribology test is needed in an environment which replicates artificial joints to confirm the acceptability of these findings.
Biological components of synovial fluid and their concentration play a crucial role in the lubrication mechanism of artificial joints, particularly boundary lubrication. The purpose of this review was to summarise and critically analyse the lubrication mechanism and their tribological outcomes to artificial joints. Thirteen papers published between 01/01/2003 and 28/02/2013 met the inclusion criteria for the review. Four major biological components of synovial fluid (albumin, globulin, hyaluronic acid and lubricin) were found to have an influence on film thickness, friction coefficient and wear rate. The role of these components was reported to be varied, depending on not only their composition and concentration but also surface material properties, wettability, temperature and pressure. The findings suggest that an appropriate synovial fluid composition should be represented in a simulated body fluid in order to evaluate an implant material and subsequently to conduct biotribology tests.
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