A lexicon for wear of metal-on-metal hip prostheses.

Research on metal-on-metal (MoM) hip bearings has generated an extensive vocabulary to describe the wear processes and resultant surface damage. However, a lack of consistency and some redundancy exist in the current terminology. To facilitate the understanding of MoM tribology and to enhance communication of results among researchers and clinicians, we propose four categories of wear terminology: wear modes refer to the in vivo conditions under which the wear occurred; wear mechanisms refer to fundamental wear processes (adhesion, abrasion, fatigue, and tribochemical reactions); wear damage refers to the resultant changes in the morphology and/or composition of the surfaces; and wear features refer to the specific wear phenomena that are described in terms of the relevant modes, mechanisms, and damage.

Accuracy of methods for calculating volumetric wear from coordinate measuring machine data of retrieved metal-on-metal hip joint implants.

This study compared the accuracy and sensitivity of several numerical methods employing spherical or plane triangles for calculating the volumetric wear of retrieved metal-on-metal hip joint implants from coordinate measuring machine measurements. Five methods, one using spherical triangles and four using plane triangles to represent the bearing and the best-fit surfaces, were assessed and compared on a perfect hemisphere model and a hemi-ellipsoid model (i.e.

Fracture of a cross-linked polyethylene liner: a multifactorial issue.

A limited number of reports have detailed the cause of fracture of a highly cross-linked polyethylene liner. Typically, the fractures have occurred in a region of thin and/or unsupported polyethylene, in association with superiorly directed edge loading conditions secondary to an excessively inclinated acetabular component. This case report details an unusual fracture mechanism of a 5-mrad cross-linked liner caused by horizontal loading conditions.

Wear versus thickness and other features of 5-Mrad crosslinked UHMWPE acetabular liners.

Background: The low wear rates of crosslinked polyethylenes provide the potential to use larger diameters to resist dislocation. However, this requires the use of thinner liners in the acetabular component, with concern that higher contact stresses will increase wear, offsetting the benefits of the crosslinking.

Questions/purposes: We asked the following questions: Is the wear of conventional and crosslinked polyethylene liners affected by ball diameter, rigidity of backing, and liner thickness? Are the stresses in the liner affected by thickness?

Methods: Wear rates were measured in a hip simulator and stresses were calculated using finite element modeling.

Metal wear particles: What we know, what we do not know, and why.

The importance of wear particle characterization for orthopaedic implants has long been established in the hip and knee arthroplasty literature. With the increasing use of motion preservation implants in the spine, the characterization of wear debris, particularly metallic nature, is gaining importance. An accurate morphological analysis of wear particles provides for both a complete characterization of the biocompatibility of the implant material and its wear products, and an in-depth understanding of the wear mechanisms, ion release, and associated corrosive activity related to the wear particles.

How have wear testing and joint simulator studies helped to discriminate among materials and designs?

Historically, hip joint simulators most often have been used to model wear of a bearing surface against a bearing surface. These simulators have provided highly accurate predictions of the in vivo wear of a broad spectrum of bearing materials, including cross-linked polyethylenes, metal-on-metal, ceramic-on-ceramic, and others in development. In recent years, more severe conditions have been successfully modeled, including jogging, stair climbing, ball-cup micro separation, third-body abrasion, and neck-socket impingement.

The lexicon of polyethylene wear in artificial joints.

The analysis of wear on polyethylene components that have been retrieved after use in patients has provided invaluable understanding of how wear occurs in vivo, and how it may be minimized through improved materials and implant design. The great number of such studies that have been published over the past three decades has lead to an extensive vocabulary to describe the tribology of prosthetic joints. However, these also have led to some confusion, due to the occasional misuse of terms from classical tribology, along with the use of multiple terms to describe the same wear phenomenon, and vice versa.

Accuracy of measurement of polyethylene wear with use of radiographs of total hip replacements.

Background: Although a number of methods are used to estimate polyethylene liner wear from radiographs of total hip replacements, there is no consensus with regard to the accuracy of these methods. The purpose of this study was to compare the accuracy of several such measurement methods with use of both laboratory radiographs and routine clinical radiographs.

Methods: A phantom apparatus was designed to simulate random values of three-dimensional wear, with varying degrees of cup abduction and anteversion, and to obtain anteroposterior and cross-table lateral radiographs with each value.

Long-term radiographic changes in cemented total hip arthroplasty with six designs of femoral components.

Measurements were made from annual follow-up radiographs, obtained over 27.6 years, of 860 cemented total hip arthroplasties implanted by one surgeon. Femoral components were made of stainless steel or titanium alloy, were non-modular, and were all fixed with cement, and acetabular cups were all-polyethylene and were fixed with cement.

Interaction of oxidation and crosslinking in gamma-irradiated ultrahigh molecular-weight polyethylene.

The interaction between oxidation and crosslinking in gamma-irradiated ultrahigh molecular-weight polyethylene with and without artificial aging was studied. The effect of the atmosphere during irradiation (air vs. low oxygen) occurred primarily within about 0.