The purpose of this study was to assess a new metal component finishing designed to improve total knee prosthesis durability. Wear of ultrahigh molecular-weight polyethylene (UHMWPE), with generation of submicrometer- and micrometer-sized particles, has been associated with osteolysis and artificial joint failure. Wear extent is influenced by several factors, some of which are related to manufacturing.
Methods
UHMWPE wear was assessed in metal prosthesis components finished with the Microloy® technology and in traditionally finished components by wear simulation experiments (pin on disk and knee simulator tests) and analysis of wear debris.
Results
Microloy®-finished prosthesis showed a 48.5% reduction in UHMWPE total weight loss compared with traditional components (P=0.002). A statistically significant (P<0.05) reduction of UHMWPE debris were detected from the Microloy®-finished compared with the traditionally finished components.
Conclusions
These findings suggest the Microloy® metal finishing may enhance the long-term performance of knee prostheses.
WillertH.G., SemlitschM.Reactions of the articular capsule to wear products of artificial joint prostheses.J Biomed Mater Res1977; 11: 157–64.
2.
HirakawaK., BauerT.W., StulbergB.N., WildeA.H.Comparison and quantitation of wear debris of failed total hip and total knee arthroplasty.J Biomed Mater Res1996; 31: 257–63.
3.
KobayashiS., OzekiK., HirakuriK.K., AokiH.The size and shape of particulate polyethylene wear debris in total joint replacements.Proc Inst Mech Eng H1997; 211: 11–5.
4.
SchmalzriedT.P., JastyM., HarrisW.H.Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space.J Bone Joint Surg Am1992; 74: 849–63.
5.
SchmalzriedT.P., JastyM., RosenbergA., HarrisW.H.Polyethylene wear debris and tissue reactions in knee as compared to hip replacement prostheses.J Appl Biomater1994; 5: 185–90.
6.
HahnD.W., WolfarthD.L., ParksN.L.Characterization of submicron polyethylene wear debris from synovial-fluid samples of revised knee replacements using a light-scattering technique.J Biomed Mater Res1996; 31: 355–63.
7.
HirakawaK., BauerT.W., StulbergB.N., WildeA.H., BordenL.S.Characterization of debris adjacent to failed knee implants of 3 different designs.Clin Orthop.1996; 331: 151–8.
8.
ShanbhagA.S., BaileyH.O., HwangD.S., ChaC.W., ErorN.G., RubashH.E.Quantitative analysis of ultrahigh molecular weight polyethylene (UHMWPE) wear debris associated with total knee replacements.J Biomed Mater Res2000; 53: 100–10.
9.
WolfarthD.L., HanD.W., BusharG., ParksN.L.Separation and characterization of polyethylene wear debris from synovial fluid and tissue samples of revised knee replacements.J Biomed Mater Res1997; 34: 57–61.
10.
LewisG.Polyethylene wear in total hip and knee arthroplasties.J Biomed Mater Res1997; 38: 55–75.
11.
NaudieD.D., AmmeenD.J., EnghG.A., RorabeckC.H.Wear and osteolysis around total knee arthroplasty.J Am Acad Orthop Surg2007; 15: 53–64.
12.
JastyM., RubashH.E., MuratogluO.Highly cross-linked polyethylene. The debate is over—in the affirmative.J Arthroplasty2005; 20: 55–8.
13.
MuratogluO.K., MarkA., VittetoeD.A., HarrisW.H., RubashH.E.Polyethylene damage in total knees and use of highly crosslinked polyethylene.J Bone Joint Surg Am2003; 85-A: S7–S13.
14.
RiesM.D.Highly cross-linked polyethylene. The debate is over—in opposition.J Arthroplasty2005; 20: 59–62.
15.
WannomaeK.K., ChristensenS.D., MicheliB.R., RowellS.L., SchroederD.W., MuratogluO.K.Delamination and adhesive wear behavior of α-tocopherol-stabilized irradiated UHMWPE.J Arthroplasty2010; 25: 635–43.
16.
PuloskiS.K.T., McCaldenR.W., MacDonaldS.J., BourneR.B., RorabeckC.H.Surface analysis of posterior stabilized femoral components used in total knee arthroplasty.J Arthroplasty2003; 18: 822–6.
17.
LancasterJ.G., DowsonD., IsaacG.H., FisherJ.The wear of ultra-high molecular weight polyethylene sliding on metallic and ceramic counterfaces representative of current femoral surfaces in joint replacement.Proc Inst Mech Eng H1997; 211: 17–24.
18.
Chapman-SheathP., CainS., BruceW.J., ChungW.K., WalshW.R.Surface roughness of the proximal and distal bearing surface of mobile bearing total knee prostheses.J Arthroplasty2002; 17: 713–7.
19.
BrummittK., HardakerC.S., McCullaghP.J., DrabuK.J., SmithR.A.Effect of counterface material on the characteristics of retrieved uncemented cobalt-chromium and titanium alloy hip replacements.Proc Inst Mech Eng H1996; 210: 191–5.
CucklerJ.M., BearcroftJ., AsgianM.S.Femoral head technologies to reduce polyethylene wear in total hip arthroplasty.Clin Orthop1995; 317: 57–63.
22.
FalezF., La CavaF., PanegrossiG.Femoral prosthetic heads and their significance in polyethylene wear.Int Orthop2000; 24: 126–9.
23.
HallR.M., SineyP., UnsworthA.The effect of surface topography of retrieved femoral heads on the wear of UHMWPE sockets.Med Eng Phys1997; 19: 711–9.
24.
LancasterJ.G., DowsonD., IsaacG.H.The wear of ultra-high molecular weight polyethylene sliding on metallic and ceramic counterfaces representative of current femoral surfaces in joint replacement.Proc Inst Mech Eng H1997; 214: 17–24.
25.
WasielewskiR.C., ParksN., WilliamsI., SurprenantH., CollierJ.P., EnghG.Tibial insert undersurface as a contributing source of polyethylene wear debris.Clin Orthop1997; 345: 53–9.
26.
JonesV.C., BartonD.C., FitzpatrickD.P., AugerD.D., StoneM.H., FisherJ.An experimental model of tibial counterface polyethylene wear in mobile bearing knees: the influence of design and kinematics.Biomed Mater Eng1999; 3: 189–96.
27.
JonesV.C., WilliamsI.R., AugerD.D.Quantification of third body damage to the tibial counterface in mobile bearing knees.Proc Inst Mech Eng H2001; 2: 171–9.
28.
BartelD.L., BicknellV.L., WrightT.M.The effect of conformity, thickness, and material on stresses in ultra-high molecular weight components for total joint replacement.J Bone Joint Surg Am1986; 7: 1041–51.
29.
WernerF., FosterD., MurrayD.G.The influence of design on the transmission of torque across knee prostheses.J Bone Joint Surg Am1978; 3: 342–48.
30.
SpectorB.M., RiesM.D., BourneR.B., SauerW.S., LongM., HunterG.Wear performance of ultra-high molecular weight polyethylene on oxidized zirconium total knee femoral components.J Bone Joint Surg Am2001; 83-A Suppl 2: 80–6.
31.
OonishiH., UenoM., KimS.C., OonishiH., IwamotoM., KyomotoM.Ceramic versus cobalt-chrome femoral components; wear of polyethylene insert in total knee prosthesis.J Arthroplasty2009; 24: 374–82.
32.
MinodaY., KobayashiA., IwakiH.Polyethylene wear particle generation in vivo in an alumina medial pivot total knee prosthesis.Biomaterials2005; 26: 6034–40.
33.
MedelF.J., KurtzS.M., HozackW.J.2009. Gamma inert sterilization: a solution to polyethylene oxidation?J Bone Joint Surg Am91: 839–49.
34.
ChiesaR., MoscatelliM., GiordanoC., SiccardiF., CigadaA.Influence of heat treatment on structural, mechanical and wear properties of crosslinked UHMWPE.J Appl Biomater Biomech2004; 2: 20–8.
35.
Brach del PreverE.M., BistolfiA., CostaL.UHMWPE for arthroplasty: Past or future?J Orthop Traumatol2009; 10: 1–8.
36.
BragdonC.R., O'ConnorD.O., LowensteinJ.D., JastyM., BiggsS.A., HarrisW.H.A new pin-on-disk wear testing method for simulating wear of polyethylene on cobalt-chrome alloy in total hip arthroplasty.J Arthroplasty2001; 16: 658–65.
37.
FisherJ., StoneM.H., InghamE.Wear of ultra high molecular weight polyethylene.Institute of Medical and Biological Engineering, University of Leeds, 2003.
38.
PaulJ.P.Forces transmitted by joints in the human body.Proc Inst Mech Eng H.1966; 181: 8–15.
39.
NiedzwieckiS., KlapperichC., ShortJ., JaniS., RiesM., PruittL.Comparison of three joint simulator wear debris isolation techniques: acid digestion, base digestion, and enzyme cleavage.J Biomed Mater Res2001; 56: 245–9.
40.
TipperJ.L., InghamE., HaileyJ.L.Quantitative analysis of polyethylene wear debris, wear rate and head damage in retrieved Charnley hip prostheses.J Mater Sci Mater Med2000; 11: 117–24.
41.
SchmalzriedT.P., CampbellP., SchmittA.K., BrownI.C., AmstutzH.C.Shapes and dimensional characteristics of polyethylene wear particles generated in vivo by total knee replacements compared to total hip replacements.J Biomed Mater Res1997; 38: 203–10.
42.
BeauléP.E., CampbellP.A., WalkerP.S.Polyethylene wear characteristics in vivo and in a knee stimulator.J Biomed Mater Res2002; 60: 411–9.
43.
JoyceT.J., Unsworth A Wear studies of all UHMWPE couples under various bio-tribological conditions.J Appl Biomater Biomech2004; 2: 29–34.
44.
MoscatelliM., FarèS., DelvecchioE.Structural, mechanical and wear resistance assessment of UHMWPE orthopedic components.J Appl Biomater Biomech2006; 4: 165–71.
45.
MargeviciusK.J., BauerT.W., McMahonJ.T., BrownS.A., MerrittK.Isolation and characterization of debris in membranes around total joint prostheses.J Bone Joint Surg Am1994; 76: 1664–75.
46.
ShanbhagA.S., JacobsJ.J., BlackJ., GalanteJ.O., GlantT.T.Macrophage/particle interactions: Effect of size, composition and surface area.J Biomed Mater Res1994; 28: 81–90.
47.
GreenT.R., FisherJ., MatthewsJ.B., StoneM.H., InghamE.Effect of size and dose on bone resorption activity of macrophages by in vitro clinically relevant ultra high molecular weight polyethylene particles.J Biomed Mater Res2000; 53: 490–7.
48.
GreenT.R., FisherJ., StoneM., WroblewskiB.M., InghamE.Polyethylene particles of a “critical size” are necessary for the induction of cytokines by macrophages in vitro.Biomaterials1998; 19: 2297–302.
49.
MartinezM.E., MedinaS., del CampoM.T., GarciaJ.A., RodrigoA., MunueraL.Effect of polyethylene particles on human osteoblastic cell growth.Biomaterials1998; 19: 183–7.
50.
DeanD.D., SchwartzZ., LiuY.The effect of ultra-high molecular weight polyethylene wear debris on MG63 osteosarcoma cells in vitro.J Bone Joint Surg Am1999; 81: 452–61.
51.
ChiuR., MaT., SmithR.L., GoodmanS.B.Ultrahigh molecular weight polyethylene wear debris inhibits osteoprogenitor proliferation and differentiation in vitro.J Biomed Mater Res A2009; 89: 242–7.
52.
VermesC., ChandrasekaranR., JacobsJ.J., GalanteJ.O., RoebuckK.A., GlantT.T.The effects of particulate wear debris, cytokines, and growth factors on the functions of MG-63 osteoblasts.J Bone Joint Surg Am2001; 83-A: 201–11.
53.
GranchiD., CiapettiG., AmatoI.The influence of alumina and ultra-high molecular weight polyethylene particles on osteoblast–osteoclast cooperation.Biomaterials2004; 25: 4037–45.
54.
HaiderH.Tribological Assessment of UHMWPE in the Knee. In: KurtzS.M., ed. UHMWPE Biomaterials Handbook.2nd Ed.Elsevier: 2009; 381–408.
