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Biomedical subjects

H McKellop

Publications and source records attributed to H McKellop.

At least 19 recordsLinked to original sources
PubMed2003

The effect of frictional heating and forced cooling on the serum lubricant and wear of UHMW polyethylene cups against cobalt-chromium and zirconia balls.

Hip simulator tests of femoral balls of cobalt-chromium alloy or zirconia against acetabular cups of UHMW polyethylene were run with and without a coolant circulated inside the femoral balls. Without cooling, the wear of polyethylene against zirconia was about 48% lower than with cobalt-chromium alloy, but the steady-state temperature of the zirconia ball was higher (55 degrees C vs. 41 degrees C), and there was more precipitation of protein from the serum, which sometimes formed an adherent layer on the surface of the zirconia. Circulating coolant at 1-20 degrees C markedly reduced the bearing temperatures and the protein precipitation. With coolant at 4 degrees C, wear of the polyethylene against cobalt-chromium alloy was about 26% lower than against zirconia, but the macroscopic and microscopic appearance of the worn polyethylene surfaces were unlike that typically generated in vivo. With or without coolant, the morphology of the polyethylene wear debris was comparable to that generated in vivo, but the ratio of fibrillar to granular debris was higher at the reduced temperature. These results suggested that circulating coolant at an appropriate temperature could avoid overheating (due to non-stop running of the simulator), preventing excessive protein precipitation while providing wear surfaces and wear debris with morphologies closely comparable to those generated in vivo.

Artifacts↗
PubMed2000

Effect of sterilization method and other modifications on the wear resistance of acetabular cups made of ultra-high molecular weight polyethylene. A hip-simulator study.

BACKGROUND: Wear of ultra-high molecular weight polyethylene acetabular cups in hip prostheses produces billions of submicrometer wear particles annually that can cause osteolysis and loosening of the components. Thus, substantial improvement of the wear resistance of ultra-high molecular weight polyethylene could extend the clinical life span of total hip prostheses. It has become apparent that the conditions under which ultra-high molecular weight polyethylene cups have been sterilized can markedly affect their long-term wear properties, and new sterilization methods and other modifications have been developed to minimize the negative effects. METHODS: In the present study, a hip-joint simulator was used to assess whether it is preferable to sterilize ultra-high molecular weight polyethylene cups without gamma irradiation, to avoid radiation-induced oxidative degradation, or to sterilize with gamma irradiation while the cups are packaged in a suitable low-oxygen atmosphere to minimize oxidation while retaining the increased wear resistance conferred by the radiation-induced cross-linking. Ion-implanted cups and cups made of a highly crystalline polyethylene (Hylamer) also were investigated. Cups made of each material were subjected to wear-testing prior to and after artificial thermal aging to accelerate oxidative degradation. RESULTS: The results of the present study demonstrated that the cross-linking induced by gamma irradiation improves the wear resistance of ultra-high molecular weight polyethylene, while oxidation reduces it. Without thermal aging, the two types of cups that were sterilized with gamma irradiation while in low-oxygen packaging exhibited about a 50 percent lower rate of wear than did either the nonsterilized cups or the nonirradiated cups sterilized with gas plasma. There was a comparable advantage in the rate of wear after fourteen days of thermal aging. However, after thirty days of aging, the cups sterilized with gamma irradiation in low-oxygen packaging wore several times faster than did the nonirradiated cups. Ion-implanting improved the wear resistance without thermal aging, but after extensive thermal aging the oxidation and wear were greater than those of the controls. Hylamer cups (that is, those that were sterilized with gas plasma) exhibited wear properties very close to those of the nonsterilized ultra-high molecular weight polyethylene cups (the controls) with or without aging. CONCLUSIONS: Sterilizing an ultra-high molecular weight polyethylene acetabular cup without radiation (for example, with ethylene oxide or gas plasma) avoids immediate and long-term oxidative degradation of the implant but does not improve the inherent wear resistance of the polyethylene. Sterilizing with use of gamma irradiation with the implant packaged in a low-oxygen atmosphere avoids immediate oxidation and cross-links the polyethylene, thereby increasing its wear resistance, but long-term oxidation of the residual free radicals may markedly reduce the wear resistance. Ideally, cross-linking with gamma irradiation to reduce wear should be done in a manner that avoids both immediate and long-term oxidation.

Acetabulum↗
PubMed1999

Potential errors in FTIR measurement of oxidation in ultrahigh molecular weight polyethylene implants.

Potential sources of error in the use of FTIR to measure the level of oxidation in ultrahigh molecular weight polyethylene acetabular cups were evaluated using cups from a hip simulator wear study with and without artificial aging, as well as cups retrieved from clinically failed hip prostheses. Oxidation was measured as a function of depth below the bearing surface using transmission FTIR on microtomed sections of the cups. To account for the variation of the thickness of the microtomed sections, oxidation was plotted as the ratio of the absorbance of the carbonyl groups to the absorbance of a reference band at 2022 cm-1. Overnight soaking in hexane reduced the apparent levels of oxidation, presumably due to the extraction of absorbed contaminants. In cups with low to moderate levels of oxidation, the reference absorption was relatively independent of the level of oxidation and was linearly proportional to the thickness of the specimens, providing reproducible oxidation ratios. However, the scatter in the reference absorption and in the apparent oxidation ratio increased with increasing levels of oxidation and was greatest for the thickest (400 microm) microtomed sections. The profiles of the oxidation ratios for a given specimen that were plotted by the present study method could be numerically adjusted to coincide with the ratios plotted using the methods of two previous investigators, providing conversion factors that are useful for comparing results among the studies.

Animals↗
PubMed1999

Potential thermal artifacts in hip joint wear simulators.

Frictional heat was monitored during wear tests of ultrahigh molecular weight polyethylene acetabular cups bearing against femoral balls of metal or ceramic in a hip simulator, using bovine serum as a lubricant. About 1 to 2 h of continuous cycling were required for the temperature in the zone of contact between the cup and ball to rise to its maximum steady value, and this equilibrium temperature was markedly higher with increased load and/or cycling rate. Frictional heating caused substantial precipitation of the proteins from the serum and, in some of the tests running at 1.5 or 2 Hz, an adherent proteinaceous layer was observed attached to the surface of the balls. The maximum temperature was also substantially higher in tests run with the cup mounted above the ball rather than below. Surprisingly, the tests running at higher frictional torque and temperature (i.e., those with the most protein precipitation and/or adherent layers) produced the least wear of the polyethylene. This might have been due to the solid proteins that formed a protective layer between the ball and cup. Because patients with hip prostheses typically do not walk for hours without rest, the maximum temperatures in vivo are likely to be much lower than those reached in the hip simulator. Therefore, the affects of protein precipitation on the resultant wear properties of the materials should be considered potential artifacts of the hip simulator tests. Increasing the volume of the lubricant bath reduced the maximum temperatures for tests running at 1.5 Hz but had little affect at 2 Hz. Reducing the cycling rate is an effective way to avoid overheating of the specimens, but this necessarily extends the time required to complete a test.

Animals↗
PubMed1999

Development of an extremely wear-resistant ultra high molecular weight polyethylene for total hip replacements.

Osteolysis induced by ultra high molecular weight polyethylene wear debris is one of the primary factors limiting the lifespan of total hip replacements. Crosslinking polyethylene is known to improve its wear resistance in certain industrial applications, and crosslinked polyethylene acetabular cups have shown improved wear resistance in two clinical studies. In the present study, crosslinked polyethylene cups were produced by two methods. Chemically crosslinked cups were produced by mixing a peroxide with ultra high molecular weight polyethylene powder and then molding the cups directly to shape. Radiation-crosslinked cups were produced by exposing conventional extruded ultra high molecular weight polyethylene bar stock to gamma radiation at various doses from 3.3 to 100 Mrad (1 Mrad = 10 kGy), remelting the bars to extinguish residual free radicals (i.e., to minimize long-term oxidation), and then machining the cups by conventional techniques. In hip-joint simulator tests lasting as long as 5 million cycles, both types of cross-linked cups exhibited dramatically improved resistance to wear. Artificial aging of the cups by heating for 30 days in air at 80 degrees C induced oxidation of the chemically crosslinked cups. However, a chemically crosslinked cup that was aged 2.7 years at room temperature had very little oxidation. Thus, whether substantial oxidation of chemically crosslinked polyethylene would occur at body temperature remains unclear. The radiation-crosslinked remelted cups exhibited excellent resistance to oxidation. Because crosslinking can reduce the ultimate tensile strength, fatigue strength, and elongation to failure of ultra high molecular weight polyethylene, the optimal crosslinking dose provides a balance between these physical properties and the wear resistance of the implant and might substantially reduce the incidence of wear-induced osteolysis with total hip replacements.

Arthroplasty, Replacement, Hip↗
PubMed1999

Wear of gamma-crosslinked polyethylene acetabular cups against roughened femoral balls.

Crosslinking of ultrahigh molecular weight polyethylene has been shown to markedly improve its wear resistance in clinical studies and laboratory tests using hip joint simulators. However, because most of the laboratory studies have been done under clean conditions using prosthesis-quality, highly polished counterfaces, there is concern regarding how well an intentionally crosslinked polyethylene acetabular cup will resist abrasion by a femoral ball that has been damaged by third-body abrasion in vivo. To investigate this, conventional and radiation crosslinked-remelted acetabular cups of ultra-high molecular weight polyethylene were tested in a hip joint simulator bearing against smooth femoral balls and against balls with moderate and severe roughening. Cups were tested with and without aging to accelerate any oxidative degradation. The crosslinked cups were produced by exposing extruded GUR 4150 bar stock of ultrahigh molecular weight polyethylene to 5 Mrad gamma radiation under a partial vacuum and then the bars were remelted to extinguish residual free radicals. Artificial aging at 70 degrees C under 5 atm oxygen for 14 days induced negligible oxidation in the crosslinked and remelted material. Against smooth balls, the wear of the crosslinked cups, with or without aging, averaged approximately 15% of that of the conventional cups. Against the moderately rough balls, the wear rate of the conventional cups was unchanged, whereas the wear rate increased slightly for the nonaged and aged crosslinked cups, but was still only 26% and 20% of that of the conventional cups, respectively. Against extremely rough balls, the mean wear rates increased markedly for each material such that during the final 1 million cycle interval, the average wear rates of the nonaged and the aged crosslinked cups were 72% and 47% of that of the conventional cups, respectively. That is, the crosslinked polyethylene showed substantially better wear resistance than conventional polyethylene across the range of ball roughnesses, with or without accelerated aging.

Acetabulum↗
PubMed1999

Comparison of healing process in open osteotomy model and closed fracture model.

OBJECTIVE: Comparison of the healing process in open osteotomy and closed fracture models that were used to study fracture healing. DESIGN: Randomized, prospective study in experimental animals, with a recovery duration of two and four weeks. SETTING: Unrestricted cage activity with weight bearing as tolerated. ANIMALS: Thirty-four skeletally mature, female New Zealand White rabbits. INTERVENTIONS: Closed fractures and open osteotomies of the tibial diaphysis were reduced and immobilized with four-pin, double-bar external fixators. MAIN OUTCOME MEASUREMENTS: Callus circumference was measured with a tape measure, bridging callus was assessed on biplane radiographs and evaluated histologically, and torsional stiffness and maximum torque were measured. RESULTS: Periosteum damage was more severe and hematoma formation was smaller in the osteotomy model, resulting in a delay in biological healing and restoration of the biomechanical properties. CONCLUSIONS: Investigators should consider the difference between the closed fracture and open osteotomy models when selecting an animal model to investigate fracture healing.

Animals↗
PubMed1998

The influence of active shear or compressive motion on fracture-healing.

The effects of interfragmentary sliding (shear) motion, axial motion, and locked external fixation on the healing of mid-tibial closed fractures were studied in fifty-six skeletally mature New Zealand White rabbits. The fractures were fixed with use of a four-pin, double-bar frame and were allowed to heal for either two or four weeks. Four experimental conditions were evaluated: transverse and oblique fractures treated with a locked external fixator (Groups 1 and 3, respectively), transverse fractures treated with an axially telescoping fixator (Group 2), and oblique fractures treated with a sliding oblique fixator (Group 4). The maximum interfragmentary motion, recorded in vivo with an electronic motion sensor that was attached to the fixator, was 0.6 millimeter in Group 2 during the first week and then declined rapidly. In contrast, the motion in Group 4 exceeded 1.5 millimeters during the first week. The circumference of the callus in Group 4 was 11 to 23 per cent greater than that in the other groups at both two and four weeks (p < or = 0.02). At two weeks, torsional stiffness, strength, and energy absorption were comparable among Groups 1, 2, and 3. The increase in healing was most rapid for Group 4; by four weeks, the torsional strength and energy to failure of the fractures in Group 4 exceeded those in the other groups (p < or = 0.025) and reached or exceeded those of intact bone. Apparently, oblique sliding (shear) motion promoted greater cartilage differentiation and expansion of the peripheral callus than did axial motion or locked external fixation.

Animals↗
PubMed1997

Effects of cement creep on stem subsidence and stresses in the cement mantle of a total hip replacement.

In cemented total hip prostheses, the role of creep of the acrylic cement (polymethyl methacrylate, [PMMA]) in increasing or decreasing the chance of failure of the cement mantle is a subject of ongoing controversy. In the present study we used a three-dimensional finite-element model of a cemented stem to assess the influence of cement creep on subsidence of the stem, and on the stress and strain in the cement under cyclic load, both in the short and long term. The cement layer was assigned the shear and bulk creep moduli of Zimmer regular PMMA cement, which were obtained experimentally. The stem-cement interface was modeled either as (1) completely bonded, (2) completely debonded with friction, or (3) completely debonded and frictionless. Under the cyclic load some cement creep occurred with all three bonding conditions, allowing additional subsidence of the stem and a decrease in the stress components within the cement. During the unloaded period the full recovery of the preload conditions could be reached with the completely bonded and with the frictionless interfaces. With the frictional interface there was residual cement creep, residual stresses within the cement, and residual subsidence of the stem during the unloaded period; however, the reduction of the stress was at most 13% and the subsidence was about 0.46 mm. The much larger subsidence of debonded stems that is often observed clinically might be attributed to the factors which were not included in the present model, such as circumferential bone remodeling.

Biocompatible Materials↗
PubMed1997

Frictional heating of bearing materials tested in a hip joint wear simulator.

In a hip simulator wear test using bovine serum as a lubricant, the heat generated by ball-cup friction may cause precipitation of the proteins from the lubricant. The resultant accumulation of a solid layer of precipitated protein between the ball and cup could artificially protect the bearing surfaces from wear, in a manner that does not occur in vivo. Alternatively, the gradual depletion of the soluble proteins could interfere with their ability to act as boundary lubricants on the bearing surfaces, thereby artificially increasing the wear rate. Because the rate of protein precipitation may depend on the maximum temperature at the bearing surfaces during sliding, rather than the mean temperature of the bulk lubricant, this study determined the transient surface temperatures using an array of thermocouples embedded in acetabular cups of GUR 415 ultra-high molecular weight polyethylene (UHMWPE) and femoral balls of metal or ceramic, in conjunction with a finite element model of the temperature distribution. The prostheses were tested at one cycle/s under a Paul-type, physiological load profile with 2030 N maximum force, with the load cycle synchronized to the motion cycle. The steady state temperatures of the bulk lubricant were 38 degrees C for the zirconia balls, 36 degrees C for the cobalt-chromium and 33 degrees C for the alumina. However, the corresponding surface temperatures of the polyethylene, calculated with the finite element model, were 99 degrees C with zirconia ceramic, 60 degrees C with cobalt-chromium alloy, and 45 degrees C with alumina ceramic. The rank order of the surface temperatures corresponded to the relative amounts of protein that were precipitated in the test chambers during wear tests with these materials.

Animals↗
PubMed1996

Stable partial debonding of the cement interfaces indicated by a finite element model of a total hip prosthesis.

A simplified three-dimensional finite element model of the femoral component of a cemented total hip prosthesis was used to investigate whether partial debonding at the stem-cement or bone-cement interfaces propagates in a stable or unstable manner, and to assess the resultant variation of the stresses within the cement layer. The likelihood of unstable debonding under tensile failure mode was assessed both by a conventional monotonic strength criterion and by a fracture mechanics approach that took into account debonding due to fatigue loading. The model predicted that partial debonding at the cement interfaces would be stable and would not precipitate complete debonding. Among the various bonding conditions that were investigated, the maximum tensile stress within the cement layer was least with a small amount of debonding rather than with complete bonding. These results were consistent with clinical observations of nonprogressive or slowly progressive separation at cement interfaces in cemented femoral components that were otherwise well functioning and asymptomatic.

Biomechanical Phenomena↗
PubMed1996

In vivo wear of three types of metal on metal hip prostheses during two decades of use.

Wear was analyzed on 21 metal on metal hip replacements, including McKee-Farrar, Müller, and Ring, that were retrieved from patients after as many as 25 years. Light and scanning electron microscopy indicated that early wear included substantial third body abrasion, possibly from particles generated while scratches from the original polishing were being eradicated and from dislodged surface carbides. However, the main contact zones were eventually worn smoother than the original surfaces. Wear was quantified by digitizing the shapes of the components on a coordinate measuring machine and identifying those areas that deviated from the original spheric surface. On the femoral heads, wear was typically concentrated in the superomedial region, that is, on the load axis. Three cases also had substantial wear inferiorly, but there were no cases with circumferential (equatorial) wear. The long term wear rates averaged approximately 6 micrometers per year or less and produced an average of approximately 6 mm3 of metallic wear debris per year or less. Wear rate tended to increase as clearance increased over the range of 127 to 386 micrometers, and a McKee-Farrar prosthesis with the extreme clearance of 1.7 mm wore approximately 16 times faster than the average, but there was no apparent relationship between clearance and time to revision. Larger McKee-Farrar balls had less volumetric wear, on average, than smaller balls, and the Müller balls had the greatest wear, which may have been due to contact with the edges of recesses machined into the bearing zones of the Müller cups.

Biomechanical Phenomena↗
PubMed1996

Metal on metal total hip replacement workshop consensus document.

The objective of this workshop was to provide a forum to discuss the reintroduction of metal on metal bearings for clinical use in total hip arthroplasty. Approximately 100 researchers clinicians, and industry representatives presented the state of the art interpretation of the metal on metal total hip replacement's past performance, and the clinical, tribologic, and biologic considerations of all metal bearings. Based on the scientific presentations at the symposium, the extant literature, the clinical experience of the panelists, and the current regulatory, legal, and economic environment, consensus statements were developed.

Alloys↗
PubMed1996

Surface and edge wear of Björk-Shiley Delrin heart valve discs.

BACKGROUND AND AIMS OF THE STUDY: Wear of Björk-Shiley Delrin (BSD) heart valve discs is known to have occurred in some patients, possibly contributing to increased regurgitation. This paper specifically addresses surface and edge wear that have been observed on some discs of explanted BSD valves after implant durations up to 22.4 years. METHODS: The wear patterns have been documented using either photographic or scanning electron microscopic methods for 42 out of 73 explanted BSD valve discs. The remainder of the 73 discs were not available for analysis. RESULTS: One form of surface wear found on 18 out of 42 of the Delrin discs was the concentric wear of mild abrasive origin along the surface near the disc edge due to contact with the inlet and outlet struts. In five instances, surface anomalies were observed, primarily in the areas of high velocity blood flow. This paper also describes two Delrin discs with non-concentric edge wear patterns: (a) one which appears to be due to fatigue micro-chipping and abrasive wear of the disc of a 20 year BSD explant, which had fibrous tissue ingrowth, causing abnormal rotation of the disc during valve closure, and (b) a second one which is thought to have been caused by a cutting action of the knife-like stub of one inlet strut leg which had separated. Cross-sectional analyses of two explanted BSD discs, with full indent grooves on the inflow side, indicated that the Delrin material was primarily compressed under these wear grooves, rather than removed by abrasion. Hardness profiles indicated that the Delrin 150 microns below the surface was harder and would tend to prevent further deformation. A simple model describing the compound impact (impact with sliding) phenomenon is introduced to explain abrasive wear found on some explanted BSD discs. CONCLUSION: Based on the studies here and reports in the literature, the BSD heart valve appears to present a design which provides many years of service and, when wear occurs, it occurs in a manner that provides easily recognized clinical symptoms, which allow time for diagnosis and treatment.

Aortic Valve↗
PubMed1995

Isolation of predominantly submicron-sized UHMWPE wear particles from periprosthetic tissues.

A method of tissue digestion using sodium hydroxide was applied to the isolation and recovery of ultra-high-molecular-weight polyethylene (UHMWPE) particles from tissues around failed total hip replacements. Density gradient ultracentrifugation of the digested tissues was performed to separate the UHMWPE from cell debris and other particulates. Fourier transform infrared spectroscopy and differential scanning calorimetry (DSC) verified that the recovered particles were UHMWPE. When viewed by scanning electron microscopy, individual particles were clearly observed and were either rounded or elongated. The majority were submicron in size. The application of this method to the study of particles from periprosthetic tissues may elucidate aspects of biomaterial particle size and shape that are important to the biologic response to, and clinical outcome of, total joint replacement.

Calorimetry, Differential Scanning↗
PubMed1993

Biomechanical assessment of surface demineralized micro-perforated femoral diaphyseal segmental allograft.

The use of surface demineralized micro-perforated femoral allograft (SDMFA), in the form of short diaphyseal segments, is of interest for anterior thoracic and lumbar spine reconstruction. Its reported osteoinductive capacity is enhanced by demineralization, though the mechanical strength is reduced. The strength of SDMFA segments was significantly higher at 24 h of demineralization time as compared to 48 h of demineralization time. The SDMFA segments from the junction of the proximal and mid-third of the femoral diaphysis had the greatest load to failure and stiffness.

Aged↗