Abstract:More robust preclinical experimental wear simulation methods are required in order to simulate a wider range of activities, observed in different patient populations such as younger more active patients, as well as to fully meet and be capable of going well beyond the existing requirements of the relevant international standards. A new six-station electromechanically driven simulator (Simulation Solutions, UK) with five fully independently controlled axes of articulation for each station, capable of replicatin… Show more
“…4 ). Each station had six degrees of freedom with five controlled axes of motion – axial load to the femoral component, femoral flexion extension, tibial internal/external rotation, tibial anterior-posterior displacement, and tibial adduction-abduction rotation ( Abdelgaied et al, 2017a ). Fig.…”
Section: Methodsmentioning
confidence: 99%
“…The femoral distal radius was taken as the femoral centre of rotation with a polarity of anterior tibial shift (denoted as negative anterior posterior motion) that produced femoral rollback. Abduction adduction was allowed but not controlled ( Abdelgaied et al, 2017a ). Fig.…”
A more robust pre-clinical wear simulation framework is required in order to simulate wider and higher ranges of activities, observed in different patient populations such as younger more active patients. Such a framework will help to understand and address the reported higher failure rates for younger and more active patients (National_Joint_Registry, 2016). The current study has developed and validated a comprehensive combined experimental and computational framework for pre-clinical wear simulation of total knee replacements (TKR).The input mechanical (elastic modulus and Poisson’s ratio) and wear parameters of the moderately cross-linked ultra-high molecular weight polyethylene (UHMWPE) bearing material were independently measured from experimental studies under realistic test conditions, similar to the loading conditions found in the total knee replacements. The wear predictions from the computational wear simulation were validated against the direct experimental wear measurements for size 3 Sigma curved total knee replacements (DePuy, UK) in an independent experimental wear simulation study under three different daily activities; walking, deep squat, and stairs ascending kinematic conditions.The measured compressive mechanical properties of the moderately cross-linked UHMWPE material were more than 20% lower than that reported in the literature under tensile test conditions. The pin-on-plate wear coefficient of moderately cross-linked UHMWPE was significantly dependant of the contact stress and the degree of cross-shear at the articulating surfaces.The computational wear predictions for the TKR from the current framework were consistent and in a good agreement with the independent full TKR experimental wear simulation measurements, with 0.94 coefficient of determination of the framework. In addition, the comprehensive combined experimental and computational framework was able to explain the complex experimental wear trends from the three different daily activities investigated. Therefore, such a framework can be adopted as a pre-clinical simulation approach to optimise different designs, materials, as well as patient’s specific total knee replacements for a range of activities.
“…4 ). Each station had six degrees of freedom with five controlled axes of motion – axial load to the femoral component, femoral flexion extension, tibial internal/external rotation, tibial anterior-posterior displacement, and tibial adduction-abduction rotation ( Abdelgaied et al, 2017a ). Fig.…”
Section: Methodsmentioning
confidence: 99%
“…The femoral distal radius was taken as the femoral centre of rotation with a polarity of anterior tibial shift (denoted as negative anterior posterior motion) that produced femoral rollback. Abduction adduction was allowed but not controlled ( Abdelgaied et al, 2017a ). Fig.…”
A more robust pre-clinical wear simulation framework is required in order to simulate wider and higher ranges of activities, observed in different patient populations such as younger more active patients. Such a framework will help to understand and address the reported higher failure rates for younger and more active patients (National_Joint_Registry, 2016). The current study has developed and validated a comprehensive combined experimental and computational framework for pre-clinical wear simulation of total knee replacements (TKR).The input mechanical (elastic modulus and Poisson’s ratio) and wear parameters of the moderately cross-linked ultra-high molecular weight polyethylene (UHMWPE) bearing material were independently measured from experimental studies under realistic test conditions, similar to the loading conditions found in the total knee replacements. The wear predictions from the computational wear simulation were validated against the direct experimental wear measurements for size 3 Sigma curved total knee replacements (DePuy, UK) in an independent experimental wear simulation study under three different daily activities; walking, deep squat, and stairs ascending kinematic conditions.The measured compressive mechanical properties of the moderately cross-linked UHMWPE material were more than 20% lower than that reported in the literature under tensile test conditions. The pin-on-plate wear coefficient of moderately cross-linked UHMWPE was significantly dependant of the contact stress and the degree of cross-shear at the articulating surfaces.The computational wear predictions for the TKR from the current framework were consistent and in a good agreement with the independent full TKR experimental wear simulation measurements, with 0.94 coefficient of determination of the framework. In addition, the comprehensive combined experimental and computational framework was able to explain the complex experimental wear trends from the three different daily activities investigated. Therefore, such a framework can be adopted as a pre-clinical simulation approach to optimise different designs, materials, as well as patient’s specific total knee replacements for a range of activities.
“…The tibial and femoral components were paired for the duration of the investigation. Studies were carried out using a 6 station ProSim electropneumatic knee simulator (Simulation Solutions, UK) [23] (Figure 1). The simulator had six degrees of freedom with 4 controlled axes of motion.…”
Experimental in vitro simulation can be used to predict the wear performance of total knee replacements. The in vitro simulation should aim to replicate the in vivo loading, motion and environment experienced by the joint, predicting wear and potential failure whilst minimising test artefacts. Experimental wear simulation can be sensitive to environmental conditions; the environment temperature is one variable which should be controlled and was the focus of this investigation. In this study, the wear of an all‐polymer (PEEK‐OPTIMA™ polymer‐on‐UHMWPE) total knee replacement and a conventional cobalt chrome‐on‐UHMWPE implant of similar initial surface topography and geometry were investigated under elevated temperature conditions. The wear was compared to a previous study of the same implants under simulator running temperature (i.e. without heating the test environment). Under elevated temperature conditions, the wear rate of the UHMWPE tibial inserts was low against both femoral component materials (mean <2 mm3/million cycles) and significantly lower (p < 0.05) than for investigations at simulator running temperature. Protein precipitation from the lubricant onto the component articulating surfaces is a possible explanation for the lower wear. This study highlights the need to understand the influence of different variables including environmental temperature to minimise the test artefacts during wear simulation which may affect the wear rates.
“…However, a change in femoral CoR may have more of an effect on wear under the fixed kinematics of displacement control, as opposed to force control where an implant would respond to a change in testing conditions with a change in kinematics. In addition, the displacement controlled ISO Standard and other displacement control testing protocols are widely used (Abdelgaied et al, 2017;Abdel-Jaber et al, 2016Ash et al, 2000;Barnett et al, 2002Barnett et al, , 2001Brandt et al, 2011;Brockett et al, 2016Brockett et al, , 2012Galvin et al, 2009;McEwen et al, 2005;Mell et al, 2018;O'Brien et al, 2014;Okazaki et al, 2019;Popoola et al, 2010), making investigations into how the choice of CoR affects wear testing under displacement control all the more necessary.…”
A leading cause of long-term failure of total knee replacements (TKRs) is osteolysis caused by polyethylene wear particles. The current gold standard for preclinical wear testing of TKRs is mechanical knee simulators. The definition of the femoral center of flexion-extension rotation (CoR) has been identified as one possible source of variability within TKR wear tests, since the femoral curvature varies from distal to posterior. The magnitude of the influence on wear due to changes in location of femoral CoR has not been investigated in depth. During this study, a computational framework utilizing finite element analysis for modelling wear of TKRs was developed and used to investigate the influence of the location of femoral CoR on TKR polyethylene wear during standardized displacement controlled testing (ISO 14243-3:2014). The study was carried out using a 40-point Latin Hypercube Design of Experiments approach. Volumetric wear was highly correlated to femoral CoR in both the superior/inferior and anterior/ posterior directions, with a stronger relationship in the superior/inferior direction. In addition, wear scars showing linear penetration were examined, with large differences in simulations at the extreme ends of the sampling region. In this study, it was found that variations in the location of the femoral center of rotation can represent a large source of variability in the preclinical testing and evaluation of the wear performance of total knee replacements. This study represents the first attempt at quantifying the effect on wear of different femoral center of rotations across a large sampling space.
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