Alternative bearing materials for intervertebral disc arthroplasty

Grupp, Thomas M.; Meisel, Hans-J.; Cotton, Janet A.; Schwiesau, Jens; Fritz, Bernhard; Blömer, W.; Jansson, Volkmar

doi:10.1016/j.biomaterials.2009.09.064

Cited by 82 publications

(57 citation statements)

References 37 publications

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“…The use of self-mating PEEK was evaluated previously as an alternative bearing material in comparison to conventional UHMWPE on metal and other self-mating polymer combinations in the form of the Active C device [31]. The testing methodology utilized the load and motion profiles of the ISO standard at a test frequency of 1 Hz in a lubricant of 30 g/L bovine serum with the addition of 20 mM of EDTA and amphotericin to retard bacterial degradation.…”

Section: Discussionmentioning

confidence: 99%

The use of self-mating PEEK as an alternative bearing material for cervical disc arthroplasty: a comparison of different simulator inputs and tribological environments

Brown

Bao

2012

Eur Spine J

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Purpose The hypothesis for this study was that the simulated wear behavior of a hydroxyapatite coated, selfmating PEEK cervical disc arthroplasty device would be dependent on the simulated testing environment. Methods Five groups of devices were evaluated under suggested ASTM and ISO load and motion profiles. The groups utilized different testing frequencies and protein content of simulator fluid, in addition to assessing the potential for third body wear. The average wear rates were determined using linear regression analysis with a generalized estimating equation. Significant differences between groups were determined using the Wald's test. Results The simulated wear behavior was shown to be highly dependent on the testing environment, where protein content more than decreasing the cyclic loading frequency resulted in increased wear, but was not dependent on the suggested load and motion profiles. It was demonstrated that a self-mating PEEK cervical disc arthroplasty device has wear rates that are similar to existing material combinations for cervical disc arthroplasty. Conclusions This study showed that at a time when data from retrieval analyses is deficient, it is important to test the wear resistance of cervical disc arthroplasty devices under various conditions. Long-term clinical results and ongoing implant retrievals are required for validation between clinical performance and simulator inputs.

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Section: Discussionmentioning

confidence: 99%

The use of self-mating PEEK as an alternative bearing material for cervical disc arthroplasty: a comparison of different simulator inputs and tribological environments

Brown

Bao

2012

Eur Spine J

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“…4 However, cell-mediated hypersensitivity reactions (Type IV) have been well reported after metal-on-metal total hip arthroplasty and have become an increasing concern.…”

Section: Discussionmentioning

confidence: 99%

Delayed hypersensitivity reaction caused by metal-on-metal total disc replacement

Zaïri¹,

Remacle

Allaoui³

et al. 2013

SPI

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The authors report the case of a 53-year-old woman who underwent placement of a metal-on-metal total disc replacement (TDR) device for the treatment of discogenic back pain. The initial postoperative course was normal, but 2 months after surgery she started to complain of a recurrence of pain and she progressively developed cauda equina syndrome. Radiological and biological findings showed an inflammatory polyneuropathy associated with an epidural mass. A diagnosis of cell-mediated hypersensitivity reaction (Type IV) was made after patch testing showed positive reactions for 1% cobalt chloride and chromium. A decision was made to remove the TDR device and to perform a circumferential fusion. This report is intended to inform the reader that systemic metal release and hypersensitivity reaction are possible complications of metal-on-metal TDR.

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“…According to the recent literature, the wear rate of PEEK self-mating cervical disc arthroplasty is reported as 1.4 ± 0.4 mg per million cycles; the historical cervical disc control (i.e. UHMWPE against CoCrMo) has a wear rate of 1.0 ± 0.4 mg per million cycles [30].…”

Section: Discussionmentioning

confidence: 99%

“…There are plenty of studies [32][33][34] that report on the biocompatibility of PEEK wear debris, however none focus on wear debris generated in cervical TDA. A recent in-vitro wear study pointed out that the wear particle size distribution of a PEEK-on-PEEK cervical disc was from 0.23 to 0.51 m with a mean roundness of 0.5 [30]. A more targeted host tissue response study is demanded to further ascertain the biocompatibility of PEEK wear debris generated from cervical total disc replacement.…”

Section: Discussionmentioning

confidence: 99%

PEEK (Polyether-ether-ketone) Based Cervical Total Disc Arthroplasty: Contact Stress and Lubrication Analysis

Hua¹,

Shepherd²,

Dearn³

2012

TOBEJ

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This paper presents a theoretical analysis of the maximum contact stress and the lubrication regimes for PEEK (Polyether-ether-ketone) based self-mating cervical total disc arthroplasty. The NuNec ® cervical disc arthroplasty system was chosen as the study object, which was then analytically modelled as a ball on socket joint. A non-adhesion Hertzian contact model and elastohydrodynamic lubrication theory were used to predict the maximum contact stress and the minimum film thickness, respectively. The peak contact stress and the minimum film thickness between the bearing surfaces were then determined, as the radial clearance or lubricant was varied. The obtained results show that under 150 N loading, the peak contact stress was in the range 5.9 -32.1 MPa, well below the yield and fatigue strength of PEEK; the calculated minimum film thickness ranged from 0 to 0.042 m and the corresponding lambda ratio range was from 0 to 0.052. This indicates that the PEEK based cervical disc arthroplasty will operate under a boundary lubrication regime, within the natural angular velocity range of the cervical spine.

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Alternative bearing materials for intervertebral disc arthroplasty

Cited by 82 publications

References 37 publications

The use of self-mating PEEK as an alternative bearing material for cervical disc arthroplasty: a comparison of different simulator inputs and tribological environments

The use of self-mating PEEK as an alternative bearing material for cervical disc arthroplasty: a comparison of different simulator inputs and tribological environments

Delayed hypersensitivity reaction caused by metal-on-metal total disc replacement

PEEK (Polyether-ether-ketone) Based Cervical Total Disc Arthroplasty: Contact Stress and Lubrication Analysis

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