In vitro friction and lubrication of large bearing hip prostheses.

New material combinations and designs of artificial hip implants are being introduced in an effort to improve proprioception and functional longevity. Larger joints in particular are being developed to improve joint stability, and it is thought that these larger implants will be more satisfactory for younger and more physically active patients. The study detailed here used a hip friction simulator to assess the friction and lubrication properties of large-diameter hip bearings of metal-on-metal and ceramic-on-reinforced-polymer couplings. Joints of different diameters were evaluated to determine what effect, if any, bearing diameter had on lubrication. In addition, the effects of lubricant type are considered, using carboxymethyl cellulose and bovine calf serum, and the physiological lubricant is shown to be considerably more effective at reducing friction. The frictional studies showed that the metal-on-metal joints worked under a mixed lubrication regime, producing similar friction factor values to each other. The addition of bovine calf serum (BCS) reduced the friction. The ceramic-on-reinforced-polymer samples were shown to operate with high friction factors and mixed lubrication. When tested with BCS, the larger-diameter bearings showed a decrease in friction compared with the smaller-size bearings, and the addition of BCS resulted in an increase in friction, unlike the metal-on-metal system. The study demonstrated that the component's diameter had little or no influence on the lubrication and friction of the large bearing combinations tested.

In-vitro evaluation of a polyurethane compliant-layer glenoid for use in shoulder arthroplasty.

A polyurethane glenoid component has been designed and manufactured as part of a total shoulder arthroplasty (TSA) system based on compliant-layer (CL) technology. Compared with conventional TSA designs, this biomimetic approach offers reduced friction and wear and potentially improved longevity. In-vitro evaluation of the glenoid system has included loosening and stability tests, and wear measurement using a specially constructed wear simulator. The results obtained support the hypothesis that a CL glenoid design may provide improved resistance to dynamic loosening and rim erosion, and demonstrate superior wear performance over a standard ultra-high molecular weight polyethylene design. This study not only confirms the feasibility of a CL glenoid component but also highlights the potential to increase implant longevity, thereby allowing earlier surgical intervention before poor glenoid bone stock and soft tissue compromise the outcome of TSA.

Automated in-vitro testing of orthopaedic implants: a case study in shoulder joint replacement.

This investigation presents the design and preliminary validation of a single station simulator with biaxial motion and loading designed to mimic the kinematics of the glenohumeral joint during arm abduction in the scapular plane. Although the design of the glenoid holder allows the glenoid component to translate in all three axes, it is primarily loaded axially, which brings it into contact with the oscillating humeral head, but is also loaded superiorly to simulate common subluxation of the humeral head. Simulating arm abduction in the scapular plane simplifies component alignment and removes the need for anterior-posterior loading, thereby creating a stable joint without the need to simulate capsular constraints. In this more physiologically accurate simulator design, the load and motion profiles influence the contact kinematics, but the wear path is ultimately determined by the conformity and constraint designed into the bearing couple. The wear data are determined and correlated with clinically retrieved glenoid components, as well as previously reported in-vitro studies, thus verifying use of the simulator in testing alternative materials and designs. The key design features, as well as the improvements proposed through this study, can be incorporated into the design of test fixtures for any other orthopaedic implant such as the hip, knee, spine, elbow, and finger.

Characterisation of Bionate polycarbonate polyurethanes for orthopaedic applications.

Two polycarbonate polyurethanes, Bionate 75D and Bionate 80A, have been characterized for application in biomimetic joint replacement systems. Procedures involved measurement of the effects of compounding and moulding on molecular weight, melt rheometry, and mechanical testing using conditioned and aged specimens. The effects of compounding with hydroxyapatite and carbon fibres were also evaluated. With Bionate 75D moulding reduces the molecular weight by 30%. Passing the material through a twin screw extruder without filler has similar molecular weight reduction effects to injection moulding. Inclusion of carbon fibre has little additional effect on molecular weight, although moulding of the fibre filled compound causes some further degradation, and Mw is almost halved compared with the original value. Inclusion of hydroxyapatite reduces Mw in a moulded component to less than a quarter of the original value and some form of chemical interaction between the polymer and filler is presumed. The apparent melt viscosity of the Bionate 75D was reduced by the addition of both carbon fibres and hydroxyapatite and this is thought to arise from reduction in molecular weight during the compounding process and the development of shear planes at the polymer-filler interface. The polymer glass transition temperatures are shifted to slightly higher values by the inclusion of filler. The tensile test results show the reinforcing effect of the carbon fibres, but poor wetting and pull out of the fibres was evident. Water absorption results suggest that the materials stabilise after 2 weeks, but the tensile results indicate that property change occurred between 1 month and 5 months of exposure. However the shape of the stress-strain curves is not altered, but with extended water exposure is translated to lower stress levels.

Crystal ageing in irradiated ultra high molecular weight polyethylene.

Medical grade ultra high molecular weight polyethylene (UHMWPE) of two molecular weights has been gamma irradiated in air to give received doses of 3.5 and 10 Mrad and aged in air for 25 months. Differential scanning calorimetry and wide and small angle X-ray diffraction (WAX and SAX) techniques and transmission electron microscopy have been used to characterize the materials. Polymer from an orthopaedic component, retrieved 10 years after implantation, has been subjected to the same analytical programme. The X-ray diffraction data shows that following irradiation two events occur with time, first a crystal refinement process, indicated by pronounced sharpening of the SAX peak, and secondly growth of a new crystal population of reduced lamellae thickness compared to the original crystal structures, shown by the development of a bimodal SAX pattern. Following irradiation crystallinity increases with time and this second crystal population makes a significant contribution to that increase. The retrieved component shows full development of these processes. It is considered that these crystallographic changes with time are responsible for the observed time dependent changes in the mechanical properties of air irradiated UHMWPE.

Selection of elastomeric materials for compliant-layered total hip arthroplasty.

A selection procedure has been developed to identify suitable commercial materials for use in compliant-layer artificial hip joints. Mechanical requirements, notably hardness and strength, as well as biocompatibility, constituted the specification for the compliant layer. Applying these constraints, candidate materials were identified in a broad range of polymeric material classes. Detailed sourcing and literature searching helped to identify materials appropriate to the application, with suitable mechanical and physical properties, as well as a history of successful clinical use. Some likely materials were identified but were prohibited from further consideration by limited commercial availability. Physical and mechanical characterization together with literature data were used to determine the relative ranking of the candidate materials and through a weighted materials property selection procedure the materials of choice were identified. The linear segmented aromatic polyurethanes, Tecothane 1085 and Estane 5714F1, emerged as the preferred materials.

Poly n-butyl cyanoacrylate nanoparticles: a mechanistic study of polymerisation and particle formation.

Poly n-butyl cyanoacrylate has been used in the synthesis of nanoparticles by dispersion polymerisation in aqueous media. Following establishment of a thermometric procedure for assessment of monomer reactivity, the relationships between monomer-polymer conversion reactions and particle development at various pH values was investigated. Particle size was measured during the synthesis process using a laser diffraction technique and final particle character was assessed by scanning electron microscopy. Optimum conditions for particle production were a dispersion medium of pH 2.5 at a temperature of 65 degrees C, with dextran 70 used as a steric stabiliser. In the presence of dextran, following a period of equilibration, colloidally stable particles form, but in the absence of dextran particles are colloidally unstable and rapidly coalesce. Measurement of molecular weight changes through the synthesis process show an upward shift consistent with the initial formation of oligomers, which then further polymerise through a re-initiation re-polymerisation process until an equilibrium molecular weight is reached.