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Iyer KR, Keeling D, Hall RM. Verification and Validation of Advanced Control Systems for a Spinal Joint Wear Simulator. Bioengineering (Basel) 2024; 11:779. [PMID: 39199737 PMCID: PMC11352032 DOI: 10.3390/bioengineering11080779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/05/2024] [Accepted: 07/23/2024] [Indexed: 09/01/2024] Open
Abstract
Wear simulation aims to assess wear rates and their dependence on factors like load, kinematics, temperature, and implant orientation. Despite its significance, there is a notable gap in research concerning advancements in simulator control systems and the testing of clinically relevant waveforms. This study addresses this gap by focusing on enhancing the conventional proportional-integral-derivative (PID) controller used in joint simulators through the development of a fuzzy logic-based controller. Leveraging a single-input multiple-output (SIMO) fuzzy logic control system, this study aimed to improve displacement control, augmenting the traditional proportional-integral (PI) tuning approach. The implementation and evaluation of a novel Fuzzy-PI control algorithm were conducted on the Leeds spine wear simulator. This study also included the testing of dailyliving (DL) profiles, particularly from the hip joint, to broaden the scope of simulation scenarios. While both the conventional PI controller and the Fuzzy-PI controller met ISO tolerance criteria for the spine flexion-extension (FE) profile at 1 Hz, the Fuzzy-PI controller demonstrated superior performance at higher frequencies and with DL profiles due to its real-time adaptive tuning capability. The Fuzzy-PI controller represents a significant advancement in joint wear simulation, offering improved control functionalities and more accurate emulation of real-world physiological dynamics.
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Affiliation(s)
- Kaushikk Ravender Iyer
- Key Engineering Solutions Limited, Nexus Discovery Way, Leeds LS2 3AA, UK;
- School of Mechanical Engineering, University of Leeds, Woodhouse, Leeds LS2 9JT, UK
| | - David Keeling
- Key Engineering Solutions Limited, Nexus Discovery Way, Leeds LS2 3AA, UK;
| | - Richard M. Hall
- College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
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Kurdi A, Alhazmi N, Alhazmi H, Tabbakh T. Practice of Simulation and Life Cycle Assessment in Tribology-A Review. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E3489. [PMID: 32784652 PMCID: PMC7476053 DOI: 10.3390/ma13163489] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/28/2020] [Accepted: 08/04/2020] [Indexed: 02/01/2023]
Abstract
To simulate today's complex tribo-contact scenarios, a methodological breakdown of a complex design problem into simpler sub-problems is essential to achieve acceptable simulation outcomes. This also helps to manage iterative, hierarchical systems within given computational power. In this paper, the authors reviewed recent trends of simulation practices in tribology to model tribo-contact scenario and life cycle assessment (LCA) with the help of simulation. With the advancement of modern computers and computing power, increasing effort has been given towards simulation, which not only saves time and resources but also provides meaningful results. Having said that, like every other technique, simulation has some inherent limitations which need to be considered during practice. Keeping this in mind, the pros and cons of both physical experiments and simulation approaches are reviewed together with their interdependency and how one approach can benefit the other. Various simulation techniques are outlined with a focus on machine learning which will dominate simulation approaches in the future. In addition, simulation of tribo-contacts across different length scales and lubrication conditions is discussed in detail. An extension of the simulation approach, together with experimental data, can lead towards LCA of components which will provide us with a better understanding of the efficient usage of limited resources and conservation of both energy and resources.
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Affiliation(s)
- Abdulaziz Kurdi
- National Center for Building and Construction Technology, King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia;
- Material Science Institute, King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia;
| | - Nahla Alhazmi
- Material Science Institute, King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia;
- National Center for Composite and High-Performance Materials, Center of Excellence for Aeronautics, King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia
| | - Hatem Alhazmi
- National Center for Environmental Technology, King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia;
| | - Thamer Tabbakh
- Material Science Institute, King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia;
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Viitala R, Saikko V. Effect of random variation of input and various daily activities on wear in a hip joint simulator. J Biomech 2020; 106:109831. [PMID: 32517982 DOI: 10.1016/j.jbiomech.2020.109831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 11/24/2022]
Abstract
The ISO 14242-1 standard specifies fixed, simplified, sinusoidal motion and double-peak load cycles for wear testing of total hip prostheses. In order to make the wear simulation more realistic, random variation was added for the first time to the motion and load control signals of a hip joint simulator. For this purpose and for the simulation of various daily activities, computer-controlled, servo-electric drives were mounted on a biaxial hip simulator frame and successfully introduced. Random variation did not result in a statistically significant difference in the wear factor of large diameter VEXLPE liners compared with fixed sinusoidal waveforms. However, level walking according to biomechanical literature surprisingly resulted in a 134 per cent higher, and jogging in a 57 per cent lower wear factor compared with the fixed sinusoidal waveforms. These wear phenomena were likely to be caused by a variation in the lubrication conditions and frictional heating. Simplified motion waveforms may result in an underestimation of wear in walking.
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Affiliation(s)
| | - Vesa Saikko
- Aalto University School of Engineering, Finland.
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Saikko V. Effect of inward-outward rotation on hip wear simulation. J Biomech 2020; 101:109638. [DOI: 10.1016/j.jbiomech.2020.109638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/27/2019] [Accepted: 01/12/2020] [Indexed: 10/25/2022]
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Bhalekar RM, Smith SL, Joyce TJ. Hip simulator testing of the taper-trunnion junction and bearing surfaces of contemporary metal-on-cross-linked-polyethylene hip prostheses. J Biomed Mater Res B Appl Biomater 2019; 108:156-166. [PMID: 30924612 DOI: 10.1002/jbm.b.34374] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 02/18/2019] [Accepted: 03/11/2019] [Indexed: 12/28/2022]
Abstract
Adverse reaction to metal debris released from the taper-trunnion junction of modular metal-on-polyethylene (MoP) total hip replacements (THRs) is an issue of contemporary concern. Therefore, a hip simulator was used to investigate material loss, if any, at both the articulating and taper-trunnion surfaces of five 32-mm metal-on-cross-linked-polyethylene THRs for 5 million cycles (Mc) with a sixth joint serving as a dynamically loaded soak control. Commercially available cobalt-chromium-molybdenum femoral heads articulating against cross-linked polyethylene (XLPE) acetabular liners were mounted on 12/14 titanium (Ti6Al4V) trunnions. Weight loss (mg) was measured gravimetrically and converted into volume loss (mm3 ) for heads, liners, and trunnions at regular intervals. Additionally, posttest volumetric wear measurements of the femoral tapers were obtained using a coordinate measuring machine (CMM). The surface roughness (Sa) of femoral tapers was measured posttest. After 5 Mc, the mean volumetric wear rate for XLPE liners was 2.74 ± 0.74 mm3 /Mc. The CMM measurements confirmed material loss from the femoral taper with the mean volumetric wear rate of 0.045 ± 0.024 mm3 /Mc. The Sa on the worn area of the femoral taper showed a significant increase (p < 0.001) compared with the unworn area. No other long-term hip simulator tests have investigated wear from the taper-trunnion junction of contemporary MoP THRs. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:156-166, 2020.
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Affiliation(s)
- Rohan M Bhalekar
- School of Engineering, Newcastle University, Newcastle upon Tyne, NE1 7RU, England, UK
| | - Simon L Smith
- School of Engineering, Newcastle University, Newcastle upon Tyne, NE1 7RU, England, UK
| | - Thomas J Joyce
- School of Engineering, Newcastle University, Newcastle upon Tyne, NE1 7RU, England, UK
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Saikko V. Effect of wear, acetabular cup inclination angle, load and serum degradation on the friction of a large diameter metal-on-metal hip prosthesis. Clin Biomech (Bristol, Avon) 2019; 63:1-9. [PMID: 30784784 DOI: 10.1016/j.clinbiomech.2019.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 02/06/2019] [Accepted: 02/12/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The large-scale clinical problem caused by unacceptable tribological behaviour of certain large diameter metal-on-metal prosthetic hips has directed attention to adverse condition testing. High metal-on-metal wear is connected with adverse reaction to metal debris. Friction is important because high friction may be associated with high wear, risk the fixation of the cup, and cause detrimental heating of periprosthetic tissues. METHODS A friction measurement system was added to a multidirectional, established hip joint wear simulator, and its functionality was evaluated. In preliminary tests, a 50 mm diameter metal-on-metal prosthesis was tested in an optimal acetabular cup inclination angle (48°) and in a steep angle (70°) using a normal peak load (2 kN) and an increased peak load (3 kN). The test length was 100 h. Long-term adverse condition tests of 3 million cycles were run for three 52 mm metal-on-metal prostheses. The lubricant was diluted calf serum at 37 °C. FINDINGS In the 100 h tests, metal-on-metal frictional torque was not highly sensitive to the angle, load and serum degradation, and it was close to that of a conventional 28 mm prosthesis with a polyethylene cup, mostly below 5 Nm. However, a manyfold higher frictional torque (10 to 20 Nm) was observed in long-term metal-on-metal tests with substantial wear. INTERPRETATION To obtain a realistic prediction of the frictional behaviour of a hip design, long-term, multidirectional wear tests are necessary. The friction should preferably be measured during the wear test. In addition to normal conditions, adverse condition testing is strongly recommended.
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Affiliation(s)
- Vesa Saikko
- Aalto University School of Engineering, Department of Mechanical Engineering, PO Box 14300, FI-00076 Aalto, Finland.
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Bhalekar RM, Smith SL, Joyce TJ. Wear at the taper‐trunnion junction of contemporary ceramic‐on‐ceramic hips shown in a multistation hip simulator. J Biomed Mater Res B Appl Biomater 2018; 107:1199-1209. [DOI: 10.1002/jbm.b.34213] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 06/04/2018] [Accepted: 07/21/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Rohan M. Bhalekar
- School of EngineeringNewcastle University Newcastle upon Tyne NE1 7RU England
| | - Simon L. Smith
- School of EngineeringNewcastle University Newcastle upon Tyne NE1 7RU England
| | - Thomas J. Joyce
- School of EngineeringNewcastle University Newcastle upon Tyne NE1 7RU England
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Ali M, Al-Hajjar M, Partridge S, Williams S, Fisher J, Jennings LM. Influence of hip joint simulator design and mechanics on the wear and creep of metal-on-polyethylene bearings. Proc Inst Mech Eng H 2018; 230:389-97. [PMID: 27160559 PMCID: PMC4873727 DOI: 10.1177/0954411915620454] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 11/11/2015] [Indexed: 12/28/2022]
Abstract
Hip joint simulators are used extensively for preclinical testing of hip replacements. The variation in simulator design and test conditions used worldwide can affect the tribological performance of polyethylene. The aim of this study was to assess the effects of simulator mechanics and design on the wear and creep of ultra-high-molecular-weight polyethylene. In the first part of this study, an electromechanical simulator and pneumatic simulator were used to compare the wear and creep of metal-on-polyethylene components under the same standard gait conditions. In the second part of the study, the same electromechanical hip joint simulator was used to investigate the influence of kinematics on wear. Higher wear rates and penetration depths were observed from the electromechanical simulator compared with the pneumatic simulator. When adduction/abduction was introduced to the gait cycle, there was no significant difference in wear with that obtained under the gait cycle condition without adduction/abduction. This study confirmed the influence of hip simulator design and loading conditions on the wear of polyethylene, and therefore direct comparisons of absolute wear rates between different hip joint simulators should be avoided. This study also confirmed that the resulting wear path was the governing factor in obtaining clinically relevant wear rates, and this can be achieved with either two axes or three axes of rotations. However, three axes of rotation (with the inclusion of adduction/abduction) more closely replicate clinical conditions and should therefore be the design approach for newly developed hip joint simulators used for preclinical testing.
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Affiliation(s)
- Murat Ali
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Mazen Al-Hajjar
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Susan Partridge
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Sophie Williams
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - John Fisher
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK Leeds Musculoskeletal Biomedical Research Unit, The Leeds Teaching Hospital NHS Trust, University of Leeds, Leeds, UK
| | - Louise M Jennings
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
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9
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Saikko V. Friction measurement in a hip wear simulator. Proc Inst Mech Eng H 2016; 230:366-72. [DOI: 10.1177/0954411915610602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/14/2015] [Indexed: 11/16/2022]
Abstract
A torque measurement system was added to a widely used hip wear simulator, the biaxial rocking motion device. With the rotary transducer, the frictional torque about the drive axis of the biaxial rocking motion mechanism was measured. The principle of measuring the torque about the vertical axis above the prosthetic joint, used earlier in commercial biaxial rocking motion simulators, was shown to sense only a minor part of the total frictional torque. With the present method, the total frictional torque of the prosthetic hip was measured. This was shown to consist of the torques about the vertical axis above the joint and about the leaning axis. Femoral heads made from different materials were run against conventional and crosslinked polyethylene acetabular cups in serum lubrication. Regarding the femoral head material and the type of polyethylene, there were no categorical differences in frictional torque with the exception of zirconia heads, with which the lowest values were obtained. Diamond-like carbon coating of the CoCr femoral head did not reduce friction. The friction factor was found to always decrease with increasing load. High wear could increase the frictional torque by 75%. With the present system, friction can be continuously recorded during long wear tests, so the effect of wear on friction with different prosthetic hips can be evaluated.
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Affiliation(s)
- Vesa Saikko
- Department of Engineering Design and Production, School of Engineering, Aalto University, Espoo, Finland
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10
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Smith SL, Li BL, Buniya A, Lin SH, Scholes SC, Johnson G, Joyce TJ. In vitro wear testing of a contemporary design of reverse shoulder prosthesis. J Biomech 2015; 48:3072-9. [PMID: 26278181 DOI: 10.1016/j.jbiomech.2015.07.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 07/18/2015] [Accepted: 07/23/2015] [Indexed: 11/28/2022]
Abstract
Reverse shoulder arthroplasty is an increasingly common surgical intervention. However there are concerns and known limitations in relation to such joint replacement, while novel designs of reverse shoulder prostheses continue to appear on the market. Many claim to offer improvements over older designs but such assertions are difficult to validate when there is no consensus as to how such implants should be tested in vitro or even if such testing is necessary. In order to permit appropriate in vitro testing of reverse shoulder prostheses a unique, multi-station test rig was designed which was capable of applying motion in three axes to test prostheses. The shoulder simulator can apply up to 110° of motion in the flexion-extension and abduction-adduction axes and up to 90° in the internal-external rotation axis. Dynamic loading of up to 1500 N can be provided. The simulator is computer controlled so that the motions and loading associated with particular activities of daily living can be applied. A 4.5 million cycle wear test of commercially available reverse shoulder prostheses was undertaken using a 'mug to mouth' activity of daily living. Gravimetric analysis was used to characterise wear. After 4.5 million cycles of 'mug to mouth', the average wear rate of the test components was 14.3mm(3)/million cycles. Polyethylene test components showed a reduction in roughness and the median wear particle diameter was 167 nm. A three axis shoulder simulator has been designed and used to successfully test multiple samples of a commercially available reverse shoulder prosthesis.
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Affiliation(s)
- S L Smith
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK
| | - B L Li
- School of Engineering, Technology and Maritime Operations, Liverpool John Moores University, James Parsons Building, Byrom Street, England, UK
| | - A Buniya
- Biomedical Engineering Department, Al-khwarizmi Engineering College, Baghdad University, Iraq
| | - S Ho Lin
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK
| | - S C Scholes
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK
| | - G Johnson
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK
| | - T J Joyce
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK.
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Analysis of Statics and Design of Structur Parameters for a Bionic Robot Hip Joint. JOURNAL OF BIOMIMETICS BIOMATERIALS AND BIOMEDICAL ENGINEERING 2015. [DOI: 10.4028/www.scientific.net/jbbbe.22.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The hip joint is one of the body's important joints, most of the lower limb activities of the human body are inseparable from the hip joint, a novel bionic robot hip joint was proposed based on 3-DOF spherical parallel mechanism. The statics performance of the bionic robot hip joint was analyzed, and the structure parameters were designed. First, the static transmission equation of the bionic robot hip joint was established using the principle of virtual works, which simplifies the calculation process of the bionic robot hip joint. Further, using the norm in Matrix theory, the force Jacobian matrix was introduced into the statics performance evaluation index, and the statics performance evaluation index and the global torque performance evaluation index was defined, and the performance atlas of the statics performance evaluation index was plotted at the workspace of the bionic robot hip joint. Moreover the objective optimal function was established basing on the global torque performance evaluation index, and the relation of the objective optimal function and the global torque performance evaluation index were analyzed. By use of fully automatic searching method, the optimal structural parameter ranges of the bionic robot hip joint were obtained. Analysis results show that the bionic robot hip joint has good static transmission performance at initial position, and the static transmission performance is decreased with increasing the workspace. Finally, using a set of optimal structural sizes parameters, a novel bionic robot hip joint was designed, which established the theoretical foundation for the bionic robot design and apply.
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12
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Analysis of UHMWPE wear particles produced in the simulation of hip and knee wear mechanisms with the RandomPOD system. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.biotri.2015.03.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Design and Dynamic Analysis of a Novel Biomimetic Robotics Hip Joint. Appl Bionics Biomech 2015; 2015:145040. [PMID: 27018226 PMCID: PMC4745464 DOI: 10.1155/2015/145040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/12/2015] [Accepted: 03/12/2015] [Indexed: 11/17/2022] Open
Abstract
In order to increase the workspace and the carrying capacity of biomimetic robotics hip joint, a novel biomimetic robotics hip joint was developed. The biomimetic robotics hip joint is mainly composed of a moving platform, frame, and 3-RRR orthogonal spherical parallel mechanism branched chains, and has the characteristics of compact structure, large bearing capacity, high positioning accuracy, and good controllability. The functions of the biomimetic robotics hip joint are introduced, such as the technical parameters, the structure and the driving mode. The biomimetic robotics hip joint model of the robot is established, the kinematics equation is described, and then the dynamics are analyzed and simulated with ADAMS software. The proposed analysis methodology can be provided a theoretical base for biomimetic robotics hip joint of the servo motor selection and structural design. The designed hip joint can be applied in serial and parallel robots or any other mechanisms.
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Puppulin L, Leto A, Wenliang Z, Sugano N, Pezzotti G. Innovative tribometer for in situ spectroscopic analyses of wear mechanisms and phase transformation in ceramic femoral heads. J Mech Behav Biomed Mater 2014; 31:45-54. [DOI: 10.1016/j.jmbbm.2013.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 12/21/2012] [Accepted: 01/08/2013] [Indexed: 10/27/2022]
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In situ measurements of local temperature and contact stress magnitude during wear of ceramic-on-ceramic hip joints. J Mech Behav Biomed Mater 2014; 31:68-76. [DOI: 10.1016/j.jmbbm.2013.01.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 01/09/2013] [Accepted: 01/25/2013] [Indexed: 11/22/2022]
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17
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Wimmer MA, Laurent MP, Dwiwedi Y, Gallardo LA, Chipps KA, Blackmon JC, Kozub RL, Bardayan DW, Gross CJ, Stracener DW, Smith MS, Nesaraja CD, Erikson L, Patel N, Rehm KE, Ahmad I, Greene JP, Greife U. Wear measurement of highly cross-linked UHMWPE using a 7Be tracer implantation technique. J Biomed Mater Res B Appl Biomater 2013; 101:423-9. [PMID: 23359471 DOI: 10.1002/jbm.b.32868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 08/24/2012] [Accepted: 10/29/2012] [Indexed: 11/11/2022]
Abstract
The very low wear rates achieved with the current highly cross-linked ultrahigh molecular weight polyethylenes (UHMWPE) used in joint prostheses have proven to be difficult to measure accurately by gravimetry. Tracer methods are therefore being explored. The purpose of this study was to perform a proof-of-concept experiment on the use of the radioactive tracer beryllium-7 ((7)Be) for the determination of in vitro wear in a highly cross-linked orthopedic UHMWPE. Three cross-linked and four conventional UHMWPE pins made from compression-molded GUR 1050, were activated with 10(9) to 10(10) (7)Be nuclei using a new implantation setup that produced a homogenous distribution of implanted nuclei up to 8.5 μm below the surface. The pins were tested for wear in a six-station pin-on-flat apparatus for up to 7.1 million cycles (178 km). A Germanium gamma detector was employed to determine activity loss of the UHMWPE pins at preset intervals during the wear test. The wear of the cross-linked UHMWPE pins was readily detected and estimated to be 17 ± 3 μg per million cycles. The conventional-to-cross-linked ratio of the wear rates was 13.1 ± 0.8, in the expected range for these materials. Oxidative degradation damage from implantation was negligible; however, a weak dependence of wear on implantation dose was observed limiting the number of radioactive tracer atoms that can be introduced. Future applications of this tracer technology may include the analysis of location-specific wear, such as loss of material in the post or backside of a tibial insert.
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Affiliation(s)
- Markus A Wimmer
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA
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Liu F, Chen Z, Gu Y, Wang Q, Cui W, Fan W. Deformation of the Durom acetabular component and its impact on tribology in a cadaveric model--a simulator study. PLoS One 2012; 7:e45786. [PMID: 23144694 PMCID: PMC3483233 DOI: 10.1371/journal.pone.0045786] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/22/2012] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Recent studies have shown that the acetabular component frequently becomes deformed during press-fit insertion. The aim of this study was to explore the deformation of the Durom cup after implantation and to clarify the impact of deformation on wear and ion release of the Durom large head metal-on-metal (MOM) total hips in simulators. METHODS Six Durom cups impacted into reamed acetabula of fresh cadavers were used as the experimental group and another 6 size-paired intact Durom cups constituted the control group. All 12 Durom MOM total hips were put through a 3 million cycle (MC) wear test in simulators. RESULTS The 6 cups in the experimental group were all deformed, with a mean deformation of 41.78 ± 8.86 µm. The average volumetric wear rate in the experimental group and in the control group in the first million cycle was 6.65 ± 0.29 mm(3)/MC and 0.89 ± 0.04 mm(3)/MC (t = 48.43, p = 0.000). The ion levels of Cr and Co in the experimental group were also higher than those in the control group before 2.0 MC. However there was no difference in the ion levels between 2.0 and 3.0 MC. CONCLUSIONS This finding implies that the non-modular acetabular component of Durom total hip prosthesis is likely to become deformed during press-fit insertion, and that the deformation will result in increased volumetric wear and increased ion release. CLINICAL RELEVANCE This study was determined to explore the deformation of the Durom cup after implantation and to clarify the impact of deformation on wear and ion release of the prosthesis. Deformation of the cup after implantation increases the wear of MOM bearings and the resulting ion levels. The clinical use of the Durom large head prosthesis should be with great care.
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Affiliation(s)
- Feng Liu
- Department of Orthopedics, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
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Wear of metal-on-metal hip bearings: metallurgical considerations after hip simulator studies. Int J Artif Organs 2011; 34:1155-64. [PMID: 22198601 DOI: 10.5301/ijao.5000065] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2011] [Indexed: 11/20/2022]
Abstract
Metal-on-metal hip-bearing components with different percentages of carbon content (low and high carbon) were tested in 6 different configurations using a hip joint simulator. The aim of this study was to characterize metallurgical and tribological events occurring at the articulating surfaces of these articulations. Also, ion release was evaluated and correlated with wear. After the test, for the high-carbon components, carbides were observed below the matrix surface. In the low-carbon content components, most carbides were "carbide-free", while a minority were worn below the matrix surface with increased test cycles. In the cast alloy components, some carbides were pulled out resulting in micropits. Scanning microscope electron characterization of the tested specimens showed scratches and holes. The surface showed a dominant severe wear mechanism due to third-body particles. A greater amount of ions was released in the lubricant used during the wear test for the smaller diameter compared with the bigger one. This study showed that the metallurgical and tribological events taking place at the articulating surfaces of metal-metal hip implants are numerous and complex. The surface morphology after the test showed the effect of more critical working conditions with smaller diameters.
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Mertl P, Boughebri O, Havet E, Triclot P, Lardanchet JF, Gabrion A. Large diameter head metal-on-metal bearings total hip arthroplasty: preliminary results. ORTHOPAEDICS & TRAUMATOLOGY, SURGERY & RESEARCH : OTSR 2010; 96:14-20. [PMID: 20170852 DOI: 10.1016/j.rcot.2009.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Accepted: 09/17/2009] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Although the use of the metal-on-metal bearings has been validated over the long term in total hip arthroplasty (THA) for standard 28 and 32 mm diameters, and over the medium term in resurfacing procedures, the use of larger metal head size in conventional THA has not yet been extensively reported. HYPOTHESIS The large-diameter metal-on-metal head is beneficial in terms of implant stability without altering the result in terms of function and bone fixation compared to the standard 28 and 32 mm diameters. OBJECTIVE The objective was to test this hypothesis by assessing the short-term clinical and radio graphic results of a metal-on-metal large-diameter heads THA system, using cups from the resurfacing hip concept. MATERIAL AND METHODS We conducted a retrospective study on a continuous series of 106 uncemented acetabular cups (Durom) implanted in 102 patients (mean age, 66 years): 93 cases of primary or secondary coxarthrosis, 11 cases of aseptic osteonecrosis, one fracture of the femoral neck, and one case of rheumatoid arthritis of the hip. At 30 months of follow-up,the Harris Hip Score and the Merle d'Aubigné (PMA) score were calculated. The radiological investigation included comparison of the implant head with native head diameters, variations of acetabular center of rotation, inspection for implant migration, and search for a gap or radiolucent line. RESULTS The series included two post-traumatic dislocations as well as spontaneously receding tendinitis of the gluteus medius with no further recurrence. The mean Harris Hip Score improved from 49.3 preoperatively to 91.6 at the latest follow-up and the mean PMA score ranged from 12 to 17. The results were excellent for 70 cases, good for 31 cases, fair for three cases, and poor for two cases. In the last five cases, the overall results were undermined by low pain subscore,with no identifiable explanation. Restoration of the original head diameter was verified for 65 hips. No cup migration was observed. Measurement of the acetabular centre of rotation showed a mean lateralization of 1.1mm. Of the 67 immediate postoperative gaps, only two did no disappear at follow-up. Implant head diameter, cup position, and the existence of a gap were not correlated with the clinical results. DISCUSSION These results are comparable to 28 mm-diameter metal-on-metal heads in uncemented cups but with improved stability but without demonstrable alteration of the quality of the bone fixation. We found no mechanical or medical cause that could explain the five cases of persistent pain leading to fair or poor results. Long-term follow-up will validate these theoretical advantages in terms of wear and implant survival. LEVEL OF EVIDENCE IV. Retrospective series.
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Affiliation(s)
- P Mertl
- Service d'orthopédie traumatologie, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80053 Amiens cedex, France.
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Kretzer JP, Kleinhans JA, Jakubowitz E, Thomsen M, Heisel C. A meta-analysis of design- and manufacturing-related parameters influencing the wear behavior of metal-on-metal hip joint replacements. J Orthop Res 2009; 27:1473-80. [PMID: 19472378 DOI: 10.1002/jor.20921] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This article aims to clarify the influence of design- and manufacturing-related parameters on wear of metal-on-metal (MoM) joint bearings. A database search for publications on wear simulator studies of MoM bearings was performed. The results of published studies were normalized; groups with individual parameters were defined and analyzed statistically. Fifty-six investigations studying a total of 200 implants were included in the analysis. Clearance, head size, carbon content, and manufacturing method were analyzed as parameters influencing MoM wear. This meta-analysis revealed a strong influence of clearance on running-in wear for implants of 36-mm diameter and an increase in steady-state wear of heat treated components.
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Affiliation(s)
- Jan Philippe Kretzer
- Laboratory of Biomechanics, Department of Orthopaedics, University of Heidelberg, Heidelberg, Germany
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St John K. The effect of serum protein concentration on wear rates in a hip simulator. J Biomater Appl 2009; 25:145-59. [PMID: 19833674 DOI: 10.1177/0885328209347962] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ultra high molecular weight polyethylene cups, 22 mm in diameter, were aged for 5 years in the normal laboratory environment. Half of the samples had been processed by the standard radiation sterilization techniques, while the remainder had been cross-linked by a technique involving higher radiation doses and controlled temperature at the time of irradiation. The samples had been tested in a hip simulator for 5,000,000 cycles using a lubricant that had been diluted 1:1 with deionized water. Once that testing was completed, further testing was conducted using lubricant with greater and lesser serum protein concentrations, and the results compared with those that had already been recorded. Comparison of the wear rates within the study as well as to published data concerning the effect of serum concentration showed results that were consistent with assumed differences in lubrication ability at different concentrations. The results of other published studies were found to be inconsistent with each other and different from some of the results of this study. There is shown to be a need for carefully controlled and conducted studies to agree, if possible, on the importance of the serum concentration and the appropriate parameters to be used in testing, as well as variations that may be necessary with different bearing material characteristics.
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Affiliation(s)
- Kenneth St John
- University of Mississippi Medical Center, Biomedical Materials Science, Jackson, MS 39216, USA.
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Leslie I, Williams S, Brown C, Isaac G, Jin Z, Ingham E, Fisher J. Effect of bearing size on the long-term wear, wear debris, and ion levels of large diameter metal-on-metal hip replacements-An in vitro study. J Biomed Mater Res B Appl Biomater 2008; 87:163-72. [PMID: 18386846 DOI: 10.1002/jbm.b.31087] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hip resurfacing arthroplasty has become a popular alternative to conventional hip surgery. Surface replacements with bearing sizes of 55 mm (n = 5) and 39 mm (n = 5) were tested in a hip simulator for 15 million cycles (Mc). Wear debris was isolated from the serum lubricant and characterized by field emmitting gun scanning electorn microscopy, and ion levels were measured via inductively coupled plasma mass spectroscopy at intervals throughout the test. The 39 mm bearings showed significantly greater bedding in volumetric wear (2.58 mm(3)) compared with the 55 mm bearings (1.15 mm(3)). There was no significant difference between the steady state wear rates (1-15 Mc) between the two sizes (0.10 and 0.09 mm(3)/Mc, respectively); however, this parity only became clear after 7 Mc. The wear debris isolated was oval in morphology with a mean particle size of 28 nm and a range of 9-108 nm. The Co levels measured at 0.13 Mc were significantly greater than at 3.6 Mc for both bearing sizes (10926 ppb and 176 ppb, respectively). After 0.5 Mc, the Co levels from the 39 mm bearings were significantly higher than the 55 mm (11,007 vs. 1475 ppb). The wear results support previous findings showing that increasing the femoral head size decreased volumetric bedding in wear. The ion levels measured suggest both bearing sizes have similar initial wear rates; however, the 55 mm bearings reach steady state wear more rapidly.
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Affiliation(s)
- Ian Leslie
- Institute of Medical & Biological Engineering, University of Leeds, Leeds, United Kingdom
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Affatato S, Spinelli M, Zavalloni M, Mazzega-Fabbro C, Viceconti M. Tribology and total hip joint replacement: Current concepts in mechanical simulation. Med Eng Phys 2008; 30:1305-17. [DOI: 10.1016/j.medengphy.2008.07.006] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Revised: 07/16/2008] [Accepted: 07/18/2008] [Indexed: 10/21/2022]
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Affatato S, Spinelli M, Zavalloni M, Leardini W, Viceconti M. Predictive role of the Λ ratio in the evaluation of metal-on-metal total hip replacement. Proc Inst Mech Eng H 2008; 222:617-28. [DOI: 10.1243/09544119jeim370] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The wear of metal-on-metal bearings is affected by various design parameters, such as the clearance or surface roughness. It would be very useful to have a significant indicator of wear according to these design parameters, such as the Λ ratio. Three different batches of cast high- and low-carbon cobalt—chromium hip implants (28 mm, 32 mm, and 36 mm diameters) were tested in a hip joint simulator for 2 × 106 cycles. Bovine calf serum was used as lubricant, and the samples were weighed at regular intervals during the test. The predictive role of the Λ ratio on the wear behaviour was investigated. Three different configurations were tested to explore the wear rate for a broad range of Λ ratios. The results of these studies clearly showed that the femoral heads of 36 mm diameter had the best wear behaviour with respect to the other two smaller configurations tested. From a predictive point of view, the Λ ratios associated with the configurations tested could clearly indicate that the femoral heads of 36 mm diameter worked in the mixed-lubrication regime (Λ>1); all the smallest configurations (28 mm size) had λ< 1, thus showing their aptitude to work in the boundary lubrication regime, with substantially higher volume depletion due to wear. The Λ values associated with the 32 mm size varied in a range around 1 (0.95<Λ<1.16), suggesting the possibility of operating in the mixed-lubrication regime.
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Affiliation(s)
- S Affatato
- Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - M Spinelli
- Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - M Zavalloni
- Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - W Leardini
- Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - M Viceconti
- Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna, Italy
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Abstract
STUDY DESIGN In vitro wear simulation. OBJECTIVE To determine the type and amount of wear produced by experimental metal-on-metal artificial discs for the lumbar spine. To minimize the amount of wear by changing the carbon content, clearance, and presence of a keel and notch. SUMMARY OF BACKGROUND DATA In contrast to the extensive number of hip joint replacement simulator studies examining the effects of individual design variables on wear, existing artificial lumbar disc wear publications have measured wear using only the final version of each product. That is, the effects of individual variables such as material, diameter, or clearance on wear of artificial discs are not known, even though the importance of such variables has been established in artificial hip wear studies. METHODS Experimental metal-on-metal artificial discs for the lumbar spine were tested in a 3-station, biaxial spine wear simulator designed and constructed by the investigators. Two versions of the implants were manufactured with differences in carbon content, clearance, and the presence of a keel. Additionally, implants were tested with or without a surgical notch. RESULTS The wear rates of the experimental metal-on-metal lumbar discs in the current study ranged from 6.2 to 15.8 mm3/million cycles. However, changing the carbon content of the ball from low to high, decreasing the initial clearance, and eliminating the anteroposterior keel reduced the wear rate from 12.4 to 7.6 mm3/million cycles. Furthermore, removing the surgical notch reduced the wear rate from 7.6 to 6.2 mm3/million cycles. The surface damage was generally consistent with low lubrication and varying degrees of abrasive and fatigue wear, with impingement of nonbearing surfaces observed at 1.5 million cycles for the longer-term test. CONCLUSION Although the implants tested in the current study were experimental, the results suggest that metal-on-metal lumbar discs have the potential to produce wear of this magnitude and mechanism in vivo. Therefore, careful consideration of individual design variables, including those considered in the current study, is necessary to avoid production of excessive wear in artificial lumbar discs.
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Scholes SC, Unsworth A. The wear properties of CFR-PEEK-OPTIMA articulating against ceramic assessed on a multidirectional pin-on-plate machine. Proc Inst Mech Eng H 2007; 221:281-9. [PMID: 17539583 DOI: 10.1243/09544119jeim224] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In an attempt to prolong the lives of rubbing implantable devices, several 'new' materials have been examined to determine their suitability as joint couplings. Tests were performed on a multidirectional pin-on-plate machine to determine the wear of both pitch and PAN (polyacrylonitrile)-based carbon fibre reinforced-polyetheretherketone (CFR-PEEK-OPTIMA) pins articulating against both BioLox Delta and BioLox Forte plates (ceramic materials). Both reciprocation and rotational motion were applied to the samples. The tests were conducted using 24.5 per cent bovine serum as the lubricant (protein concentration 15 g/l). Although all four material combinations gave similar low wear with no statistically significant difference (p > 0.25), the lowest average total wear of these pin-on-plate tests was provided by CFR-PEEK-OPTIMA pitch pins versus BioLox Forte plates. This was much lower than the wear produced by conventional joint materials (metal-on-polyethylene) and metal-on-metal combinations when tested on the pin-on-plate machine. This therefore indicates optimism that these PEEK-OPTIMA-based material combinations may perform well in joint applications.
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Affiliation(s)
- S C Scholes
- Centre for Biomedical Engineering, School of Engineering, Durham University, Durham, UK.
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Affatato S, Leardini W, Jedenmalm A, Ruggeri O, Toni A. Larger diameter bearings reduce wear in metal-on-metal hip implants. Clin Orthop Relat Res 2007; 456:153-8. [PMID: 17065844 DOI: 10.1097/01.blo.0000246561.73338.68] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Metal-on-metal hip arthroplasty has the longest clinical history of all total arthroplasties. We asked whether large diameter femoral heads would result in less wear than those with small diameters. We also asked if there is a threshold diameter that ensures good wear behavior. We tested three batches of cast high-carbon cobalt-chromium-molybdenum hip implants (28 mm, 36 mm, and 54 mm diameters) in a hip simulator for 5 million cycles. We used bovine serum as lubricant and weighed the samples at regular intervals during testing. The 28-mm configuration had almost twice the wear of the 54-mm configuration, but we observed no difference between the 36-mm and the 54-mm configurations. The similarity in the wear performances of the larger configurations supports the presence of a threshold diameter that ensures good wear behavior.
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Affiliation(s)
- S Affatato
- Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna, Italy.
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Saikko V. Effect of contact pressure on wear and friction of ultra-high molecular weight polyethylene in multidirectional sliding. Proc Inst Mech Eng H 2006; 220:723-31. [PMID: 17117762 DOI: 10.1243/09544119jeim146] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Computational wear models need input data from valid tribological tests. For the wear model of a total hip prosthesis, the contact pressure dependence of wear and friction of ultra-high molecular weight polyethylene (UHMWPE) against polished CoCr in diluted calf serum lubricant was studied, and useful input data produced. Two test devices were designed and built: a heavy load circularly translating pin-on-disc (HL-CTPOD) wear test device and an HL-CTPOD friction measurement device. Both can be used with a wide range of loads. The wear surface diameter of the test pin was kept constant at 9 mm, whereas the load was varied so that the nominal contact pressure ranged from 0.1 to 20 MPa. The wear factor decreased with increasing contact pressure, whereas the coefficient of friction first increased with increasing contact pressure with low pressure values and then decreased. Up to the pressure of 2.0 MPa, the wear mechanisms and wear factors were in good agreement with clinical findings. In the critical range of 2.0-3.5 MPa, the wear mechanisms and wear factors started to differ from clinical ones, and the decrease of the wear factor steepened. The discrepancy became more and more evident as the pressure was gradually increased beyond 3.5 MPa. It appears that the pressure value of 2.0 MPa should not be exceeded in pin-on-disc wear tests that are to reproduce the clinical wear of UHMWPE acetabular cups.
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Affiliation(s)
- V Saikko
- Department of Mechanical Engineering, Helsinki University of Technology, P.O. Box 4300, Helsinki, FIN-02015 HUT, Finland.
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Affatato S, Leardini A, Leardini W, Giannini S, Viceconti M. Meniscal wear at a three-component total ankle prosthesis by a knee joint simulator. J Biomech 2006; 40:1871-6. [PMID: 17014854 DOI: 10.1016/j.jbiomech.2006.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Accepted: 08/08/2006] [Indexed: 10/24/2022]
Abstract
Despite the fundamental value of wear simulation studies to assess wear resistance of total joint replacements, neither specialised simulators nor established external conditions are available for the human ankle joint. The aim of the present study was to verify the suitability of a knee wear simulator to assess wear rates in ankle prostheses, and to report preliminary this rate for a novel three-component total ankle replacement design. Four intact 'small' size specimens of the Box ankle were analysed in a four-station knee wear simulator. Special component-to-actuator holders were manufactured and starting spatial alignment of the three-components was sought. Consistent load and motion cycles representing conditions at the ankle joint replaced exactly with the prosthesis design under analysis were taken from a corresponding mechanical model of the stance phase of walking. The weight loss for the three specimens, after two million cycles, was 32.68, 14.78, and 62.28mg which correspond to a linear penetration of 0.018, 0.008, and 0.034mm per million-cycle, respectively for the specimens #1, #2, and #3. The knee wear simulator was able to reproduce load-motion patterns typical of a replaced ankle. Motion of the meniscal bearing in between the tibial and talar components was smooth, this component remaining in place and in complete congruence with the metal components throughout the test.
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Affiliation(s)
- S Affatato
- Istituti Ortopedici Rizzoli, Laboratorio di Tecnologia Medica, Via di Barbiano 1/10, 40136 Bologna, Italy.
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