Model validation for estimating taper microgroove deformation during total hip arthroplasty head-neck assembly.

Total hip arthroplasty (THA) failure and the need for revision surgery can result from fretting-corrosion damage of the head-neck modular taper junctions. Prior work has shown that implant geometry, such as microgrooves, influences damage on retrieved implants. Microgroove deformation within the modular taper junction occurs when the female head taper meets the male stem taper during THA surgical procedure. The objective of this work was to validate microgroove deformation after head-neck THA assembly as calculated by finite element analysis (FEA). Four 28 mm CoCrMo head tapers and four Ti6Al4V stem tapers were scanned via white light interferometry. Heads were assembled onto stem tapers until 6kN reaction force was achieved, followed by head removal using a cut-off machine. The stem tapers were then rescanned and analyzed. Simultaneously, a 2D axisymmetric FEA model was developed and assembled per implant geometries and experimental data. For experiments and FEA, the mean change in microgroove height was 1.23 µm and 1.40 µm, respectively. The largest microgroove height change occurred on the proximal stem taper due to the conical angles of the head and stem tapers. FEA showed that the head-stem assembly induced high stresses and microgroove peaks flattening. 76-89% and 91-100% of the microgrooves in the experiments and FEA, respectively, showed height changes along the contact length of the stem taper. A validated FEA model of THA head-neck modular junction contact mechanics is essential to identifying implant geometries and surface topographies that can potentially minimize the risk of fretting and fretting-corrosion at modular junctions.

Evaluation of Total Ankle Arthroplasty Using Highly Crosslinked Ultrahigh-Molecular-Weight Polyethylene Subjected to Physiological Loading.

BACKGROUND: Highly crosslinked polyethylene (HXLPE) was developed for its superior wear properties in comparison to conventional polyethylene (CPE). Concern over fatigue resistance has prevented widespread adoption of HXLPE for use in total ankle arthroplasty (TAA). The aim of this study was to determine whether HXLPE has sufficient fatigue strength for total ankle arthroplasty under simulated physiologically relevant motion profiles and loading in the ankle. METHODS: Physiologic load and motion profiles representative of walking gait were incorporated into a computational model of a semiconstrained, fixed-bearing TAA to determine the loading state with highest stresses in the HXLPE bearing. Subsequent fatigue testing to 10 million cycles (Mc) at 5600 N was performed to assess bearing strength. RESULTS: Peak stresses in the bearing were predicted at peak axial load and peak dorsiflexion during gait, occurring near heel off. All samples withstood 10 Mc of fatigue loading at that orientation without polyethylene bearing fracture. CONCLUSION: HXLPE had sufficient fatigue strength to withstand 10 Mc of loading at more than 5 times body weight at the point of peak stresses during simulated gait in total ankle arthroplasty. CLINICAL RELEVANCE: HXLPE may be mechanically strong enough to withstand the in vivo demands of the ankle. Improvements in wear afforded by HXLPE can be obtained without compromising sufficient polyethylene strength properties in total ankle arthroplasty.

Patellofemoral interactions in walking, stair ascent, and stair descent using a virtual patella model.

Restoration of normal patella kinematics is an important clinical outcome of total knee arthroplasty. Failure of the patella within total knee systems has been documented and, upon occurrence, often necessitates revision surgery. It is thus important to understand patella mechanics following implantation, subject to load states that are typically realized during walking and other gaits. Here, a computational model of the patella is developed and used to examine the effects of walking, stair ascent, and stair descent on the development of stress and contact pressure in the patella throughout the gait cycle. Motion of the patella was governed by a combination of kinematic and force control, based on knee flexion and patellofemoral joint reaction force data from the literature. Unlike most previous analyses of full gait, quasi-static equilibrium was enforced throughout the cycle. Results indicate that, though peak forces vary greatly between the three gaits, maximum contact pressure and von Mises stress are roughly equivalent. However, contact area is larger in stair ascent and descent than walking, as patellofemoral loading, implant geometry, and polyethylene yield increase conformity between the femoral component and patella. Additionally, maximum contact pressure does not coincide with maximum load except for the case of walking. Though specific to the implant design considered here, this result has important ramifications for patella testing and emphasizes the need to characterize patella mechanics throughout gait.

Effect of impact assembly on the fretting corrosion of modular hip tapers.

The goal of this study was to determine the effect of assembly load and local assembly environmental conditions on the fretting corrosion of modular femoral stem tapers. Femoral head/taper assemblies in both similar (CoCrMo/CoCrMo) and mixed (CoCrMo/Ti-6Al-4V) alloy combinations were evaluated using an electrochemical test method. Specimens were assembled under impact loading and by hand, in both wet and dry conditions. Incremental cyclic loads ranging from 89 to 5,340 N were applied at a frequency of 3 Hz in Ringer's solution at ambient temperature. During the test, both the open circuit potential (OCP) and fretting current (i(fret)) were measured using a saturated calomel electrode (SCE) and counter electrode, respectively. The results were comparable for both mixed and similar alloy couples. Decreases in OCP and increases in i(fret) (indicators of oxide film fracture and repassivation) were seen with increasing load magnitude, often occurring at loads well below those expected clinically. OCP at the 5,340 N cyclic load ranged from -30.4 to -103.7 mV versus SCE for similar alloy couples, and -19.1 to -181.4 mV versus SCE for mixed alloy couples. Mean peak fretting currents ranged from 0.84 to 1.42 microA and 1.06 to 3.12 microA for similar and mixed alloy couples, respectively. The larger current magnitudes and more negative shifts in OCP for mixed alloy couples indicate the difference in oxide film fracture behavior between titanium and cobalt alloys. The load at which OCP began to drop (onset of fretting) was dependent upon the assembly conditions for both material couples. Specimens assembled with impact loads in air showed the highest resistance to fretting. The results of this study indicate that the assembly load and the environment both play a role in the initial stability of modular hip taper connections.