Lubrication and wear of ultra-high molecular weight polyethylene in total joint replacements

Wang, A; Essner, Aaron; Polineni, V.K.; Stark, C.; Dumbleton, J. H.

doi:10.1016/s0301-679x(98)00005-x

Cited by 302 publications

(185 citation statements)

References 23 publications

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“…Surface wear of polyethylene is not only determined by sliding distance and load [1], but also by other variables including cross shear [3,25] and the surface area [2] of the polyethylene being worn. We therefore investigated to what degree surface wear was reduced by (1) reduced levels of cross shear in rotating platform mobile-bearing knees, and (2) reduced bearing surface area in low conforming fixed-bearing knees.…”

Section: Discussionmentioning

confidence: 99%

“…In fixed-bearing knees increased cross shear and increased wear reportedly occurs with higher levels of activity, whether it be increased rotation [22] or increased lateral shift with lift off [18]. Increased cross shear also increases wear in the hip [3,25]. The rotating platform mobile-bearing knee design, which accommodates rotation on the lower articulating surface, decouples complex motions to simple unidirectional motion and low cross shear on both articulating surfaces (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Given there is a limitation to the level of cross-linking that can be applied in the knee, it is important to consider other tribological design factors that may be used to reduce polyethylene surface wear. For example, surface wear of polyethylene is not only determined by sliding distance and load [1], but also by other variables including cross shear [3,25] and the surface pressure and area [2] of the polyethylene being worn.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

2009 Knee Society Presidential Guest Lecture: Polyethylene Wear in Total Knees

Fisher

Jennings

Galvin

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Knee arthroplasties in young and active patients place a substantial increase in the lifetime tribological demand and potential for wear-induced osteolysis. Polyethylene materials have advanced in recent years, reducing the potential for oxidative degradation and delamination failure. It is timely to consider tribological design variables and their potential to reduce surface wear and the long-term risk of osteolysis. The influence of reduced cross shear in rotating platform mobile-bearing knee designs and reduced surface wear area in low conforming fixed-bearing knees has been investigated. A reduction in cross shear substantially reduced wear in both multidirectional pin-on-plate studies and in rotating platform mobile-bearing designs in knee simulator studies. A reduction in bearing surface contact area substantially reduced surface wear in multidirectional pin-on-plate simulations and in low conforming fixed-bearing knee designs in knee simulator studies. This offers potential for a paradigm shift in knee design predicated by enhanced mechanical properties of new polymer materials. We describe two distinct low-wearing tribological design solutions: (1) a rotating platform design solution with reduced cross shear provides reduced wear with conformity and intrinsic stability; and (2) a low conformity fixed bearing with reduced surface area, provides reduced wear, but has less intrinsic stability and requires good soft tissue function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

2009 Knee Society Presidential Guest Lecture: Polyethylene Wear in Total Knees

Fisher

Jennings

Galvin

et al. 2010

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Thus, orthopaedic manufacturers invested substantial resources in the commercialization of second-generation metal-on-metal [3,24,40] and ceramic-on-ceramic [14,47,107,126] hip bearings during the 1990s, culminating in the growth in the adoption of these bearings at the start of the 21st century [18]. Concurrently, polyethylene researchers at multiple institutions around the world confirmed the finding that elevated doses of radiation crosslinking would reduce wear rates by an order of magnitude during in vitro hip simulator testing [95,103,133]. Clinical researchers in Japan and South Africa reported successful long-term case series initiated in the 1970s in which polyethylene had been exposed to elevated doses of gamma radiation [56,109,111] and silane chemistry [144].…”

Section: History and Development Of Hxlpementioning

confidence: 94%

History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene

Kurtz

Gawel

Patel

2011

Clinical Orthopaedics &Amp; Related Research

398

282

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Background Highly crosslinked polyethylene (HXLPE) was introduced to reduce wear and osteolysis in total joint arthroplasty. While many studies report wear and osteolysis associated with HXLPE, analytical techniques, clinical study design and followup, HXLPE formulation and implant design characteristics, and patient populations differ substantially among investigations, complicating a unified perspective. Questions/purposes Literature on first-generation HXLPE was summarized. We systematically reviewed the radiographic wear data and incidence of osteolysis for HXLPE in hip and knee arthroplasty. Methods PubMed identified 391 studies; 28 met inclusion criteria for a weighted-averages analysis of two-dimensional femoral head penetration rates. To determine the incidence of osteolysis, we estimated a pooled odds ratio using a random-effects model.Results Weighted-averages analyses of femoral head penetration rates in HXLPE liners and conventional UHMWPE liners resulted, respectively, in a mean twodimensional linear penetration rate of 0.042 mm/year based on 28 studies (n = 1503 hips) and 0.137 mm/year based on 18 studies (n = 695 hips). The pooled odds ratio for the risk of osteolysis in HXLPE versus conventional liners was 0.13 (95% confidence interval, 0.06-0.27) among studies with minimum 5-year followup. We identified two clinical studies of HXLPE in TKA, preventing systematic analysis of outcomes. Conclusions HXLPE liner studies consistently report lower femoral head penetration and an 87% lower risk of osteolysis. Reduction in femoral head penetration or osteolysis risk is not established for large-diameter ([ 32 mm) metallic femoral heads or ceramic femoral heads of any size. Few studies document the clinical performance of HXLPE in knees.

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“…Studies concerning wear behavior of UHMWPE sliding against stainless steel have been performed, for example Atkinson et al [9], Wang et al [17,21] and Wang and Li [22]. According to their descriptions, there are three periods existing in a sliding wear process: the wearing-in period, the steady-state period and the severe wear period.…”

Section: Wear Mechanismmentioning

confidence: 99%

The computer simulation of wear behavior appearing in total hip prosthesis

Hung

Shu

et al. 2003

Computer Methods and Programs in Biomedicine

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Computer algorithms are proposed for the estimation of wear appearing in artificial hip joints using finite element analysis based on the modified Archard's wear law, contact features and an analogue wear process. A pin-on-disk plate experiment is reconstructed to assess the efficiency and validity of the algorithms proposed here. Through the successful verification of wear depth and volume loss of the pin-on-disk plate as well as the artificial hip joint, the current algorithms provide significant agreement with experiments, clinical measurements and numerical calculations and are shown to be both valid and feasible. Further investigation into the effect of femoral heads with various sizes suggests that the larger femoral head may induce larger wear volume but gives a smaller wear depth and that wear depth and volume loss are apparently nonlinearly related to the femoral head diameter. It is shown that the current algorithms are useful and helpful in understanding wear behavior for alternative or new designs of artificial hip joints and even for other analogous structures.

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Lubrication and wear of ultra-high molecular weight polyethylene in total joint replacements

Cited by 302 publications

References 23 publications

2009 Knee Society Presidential Guest Lecture: Polyethylene Wear in Total Knees

2009 Knee Society Presidential Guest Lecture: Polyethylene Wear in Total Knees

History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene

The computer simulation of wear behavior appearing in total hip prosthesis

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