Biomedical subjects

Ian C Clarke

Publications and source records attributed to Ian C Clarke.

12 recordsLinked to original sources

PubMed2006

Wear and toughness of crosslinked polyethylene for total knee replacements: a study using a simulator and small-punch testing.

Severe loading and complex kinematics in total knee replacement make wear performance and toughness of the polyethylene in tibial inserts important. We investigated wear of crosslinked polyethylene using a knee simulator and measured toughness using small-punch testing. GUR1050 rods were gamma-irradiated in air at doses from 0 to 200 kGy, annealed in nitrogen, and machined into tibial inserts. The simulator was run to 4 million cycles, and wear rates determined from weight loss. Wear rate decreased by 54, 78, and 95% as radiation dose increased from 50 to 75 to 100 kGy, respectively. At every dose, toughness was significantly less after simulator testing, but the difference between control and wear-tested polyethylene, considered to be due to fatigue damage accumulation, was smallest at 50 kGy. The simulator-tested polyethylene that received 35 to 75 kGy had slightly higher toughness than equivalent material that received no irradiation. However, the toughness of simulator-tested polyethylene that received 150 and 200 kGy was lower than that of the simulator-tested polyethylene that received no irradiation. Our results suggest that an optimal irradiation dose may exist for crosslinked polyethylene for use in TKR and that the optimum dose would be less than the 100 kGy or more that are used in some current crosslinked polyethylene for hip replacement.

Biomechanical Phenomena↗

PubMed2006

Effect of low protein concentration lubricants in hip simulators.

BACKGROUND: Proteins play an important role as boundary lubricants in vivo and in vitro. Hip simulator studies have tested various protein concentrations of lubricants. Several groups reported that nonphysiological pits were created with low protein concentrations. Our study showed details of wear findings with low protein concentrations. This may be the first mapping of the run-in wear morphology on ultra high molecular weight polyethylene (UHMWPE) cups. METHODS: The UHMWPE cups used were holding cobalt chrome (CoCr) balls. This study was run on orbital-type hip simulators at up to 1.0 million cycles (Mc). The lubricant was bovine calf serum (0, 3, 5, 7, 10, and 1 mg/ml protein concentrations). Two volumes of lubricant were used (40 and 16 ml). Volumetric wear rates were calculated and the cup surfaces were observed using reflected light microscopy (RLM) and scanning electron microscopy (SEM). RESULTS: The 40-ml volume showed a lower wear rate than the 160-ml volume. The RLM findings showed that the machine marks gradually disappeared up to 1.Mc, but there were no obvious pits on the polyethylene surface. The SEM findings showed nonphysiological wear phenomena in the 0-mg/ml protein concentration and physiological wear phenomena in the low protein concentrations. In the main bearing wear area, many nodules were observed with fibrils. In the peripheral bearing wear area, mainly ripples were observed. At the nonbearing wear area, folds were observed. CONCLUSIONS: Our study showed the microwear findings with low-protein serum: First, folds were formed, followed by ripples, and finally nodules accompanied by fibrils. During the run-in wear phase, nodules and fibrils had already appeared in the main bearing wear area. Thus, we need to investigate more details of the wear process when folds or ripples change to nodules at the main wear area in the run-in wear.

Animals↗

PubMed2006

A Study for a retrieved implant of ceramic-on-ceramic total hip arthroplasty.

A Mittelmeier-type ceramic on ceramic total hip arthroplasty (THA) was retrieved because of aseptic loosening 17 years after implantation. The extent of wear was assessed by scanning electron microscopy. The synovial fluid and the tissue surrounding the implant were also examined. Scanning electron microscopy analysis of the ball head showed that the main wear zone had grade IV wear. The stripe wear zones showed grain pullout regions (grade 5 wear). Pathologically, chronic inflammation was observed in the surrounding tissue. The debris particles in the synovial fluid were polygonal and approximately 3 x 4 microm. Thus, the Mittelmeier-type THA proved excellent wear resistance. Further longevity of ceramic on ceramic THA may indeed become a reality with improvement of the design and quality of alumina.

Arthroplasty, Replacement, Hip↗

PubMed2006

Improved wear performance with crosslinked UHMWPE and zirconia implants in knee simulation.

BACKGROUND: Suggestions for improved wear performance of total knee replacements have included replacement of standard CoCr femoral components with ceramic and replacement of 3.5-Mrad ultra-high molecular weight polyethylene (UHMWPE) inserts with 5- or 7-Mrad UHMWPE inserts. The ceramic materials used clinically have included alumina, zirconia ceramic and oxidized zirconium. PATIENTS AND METHOD: We compared both CoCr and zirconia versions of the Bi-Surface knee replacement in a 6-station knee simulator using alpha calf serum for lubrication (20 mg protein per mL) to evaluate the relative bearing performance. RESULTS: We studied the 4-way knee simulation of implant materials: zirconia ceramic, CoCr, 3.5-Mrad UHMWPE, and 7-Mrad UHMWPE. With CoCr femoral components, the 7-Mrad UHMWPE resulted in a 5- to 8-fold reduction in wear compared to the 3.5-Mrad insert. With the 3.5-Mrad insert, the zirconia bearing provided approximately 4-fold wear reduction compared to CoCr. These wear rates with standard UHMWPE were similar to published wear studies on entire knees. With the exception of the CoCr/7-Mrad and ZrO2/3.5-Mrad combinations, the wear differences were statistically significant. INTERPRETATION: The ZrO2/7-Mrad UHMWPE combination gave the best performance, with no measurable wear over the 5.5 million cycle test duration.

Arthroplasty, Replacement, Knee↗

PubMed2005

Change in UHMWPE properties of retrieved ceramic total knee prosthesis in clinical use for 23 years.

The alumina-ceramic total knee prosthesis developed by Kyocera Corp. was implanted in 1979, and was in clinical use for 23 years until total knee arthroplasty revision surgery in January 2002. It is believed that this is the longest clinical period of a ceramic total knee prosthesis reported to date in the world. In the present study, we gave consideration to the long-term clinical stability of the alumina-ceramic femoral component as well as the mechanism of in vivo degradation of ultrahigh molecular weight polyethylene (UHMWPE) based on the evaluated wear, oxidation, and fracture toughness of the retrieved UHMWPE. We concluded that the degradation of UHMWPE by progressive oxidation is an issue to be solved in the future. To moderate stress concentration, use of a thin UHMWPE insert should be avoided. The low wear rate and the mild wear pattern observed this time suggest the possibility of reduced wear of the UHMWPE against the alumina-ceramic femoral component, and the usefulness of the alumina-ceramic total knee prosthesis component was recognized even after long clinical use.

Ceramics↗

PubMed2005

Current concepts of metal-on-metal hip resurfacing.

The second-generation, metal-on-metal (MOM) bearing for total hip replacements was launched in the 1980s, and resurfacing followed in the mid-1990s. Remaining challenges include long-term bone remodeling of the femoral resurfacing and consideration of adverse MOM wear conditions. Precise understanding of manufacturing variables such as alloy types, bearing diameters, design tolerances, and surface finish is imperative in obtaining clinical consistency and safety in the patient. This review examines femoral fixation, bone remodeling, and wear studies of MOM implants and provides a brief overview of the latest outcome and retrieval data and how these data integrate with the in vitro wear studies.

Arthroplasty, Replacement, Hip↗

PubMed2004

Alumina hip joints characterized by run-in wear and steady-state wear to 14 million cycles in hip-simulator model.

The biphasic wear performance (run-in; steady-state phase) of 28-mm alumina-alumina hip implants was studied by hip simulator methods using bovine serum as the lubricant. The Biolox implants were run to 5.7 million cycles and Bioceram implants to 14.4 million cycles (Mc). Wear with all-alumina total hip replacements (THR) first showed a high wear rate of the order 1.2 mm3/Mc, lasting approximately 0.17 Mc. Overall to 0.7 Mc, the run-in phase appeared curvilinear but could be described by a linear phase averaging 0.3 mm3/Mc. From 0.7 to 1 Mc duration, the wear trend transitioned into a steady-state phase. Wear rates from 1 to 14 Mc were of the order 0.02 mm3/Mc. Surface contamination from the serum lubricant resulted in cyclic weight fluctuations of the order 0.2 mg. The transition from average run-in to steady-state phase represented a wear reduction of 13-fold. Comparing the steady-state wear value to that in standard 28-mm UHMWPE CUPS approaching 75 mm3/year, there was clearly a three-orders-of-magnitude wear superiority in favor of ceramic cups.

Aluminum Oxide↗

PubMed2004

Stripe wear rates in alumina THR--comparison of microseparation simulator study with retrieved implants.

Alumina-on-alumina hip implants with microseparation were run in a hip simulator for comparison of the nonseparation simulator mode and retrievals. The 28-, 32-, and 36-mm Biolox-forte implants were run to 5 million cycles with the use of 50% newborn calf serum. Howmedica Osteonics Trident cups with titanium backing were used in all sets. In standard (STD) and microseparation (MSX) mode, the typical biphasic wear trend was evident, but the MSX test mode had much higher magnitudes. There was a 5-fold increase for run-in wear and up to a 35-fold increase in steady-state wear. The stripe wear on the ball formed early, but did not progress in grade beyond 0.6 Mc. The locations of the stripes were similar in retrieved and simulator balls. However, the stripes from the simulator were narrower than short-term retrievals and much narrower than some long-term retrievals. The long-term retrieved balls had a grade of wear greater than the simulators. In vivo a broader range of motion occurs and this may lead to the wider stripe observed on the retrievals. These observations suggested that simulators could produce the loading and kinematics similar to a patient walking but not necessarily the variety of motions possible in the in vivo situation.

Aluminum Oxide↗

PubMed2004

Assessment of wear in extensively irradiated UHMWPE cups in simulator studies.

Higher levels of UHMWPE crosslinking currently are being advocated for improved wear resistance of acetabular cups. Pioneering Japanese studies, begun in 1971, have achieved good clinical results with UHMWPE irradiated to 1000 kGy for use with a cemented-cup design. The objective of our study was to use contemporary simulator techniques to determine the in vitro wear performance of such high-dose irradiated cups. Extruded UHMWPE cups were processed with 500, 1000, and 1500 kGy of gamma-radiation doses under vacuum, annealed, and machined to shape. The cups were mated with 26-mm alumina heads and run in a multidirectional simulator with bovine serum. Over a 6-million cycle (Mc) study, the weight loss of the nonirradiated control cups averaged 52.8 mg/Mc + 1.4% (wear = 57.2 mm(3)/Mc). In contrast, the irradiated wear cups had a consistent weight gain. Thus cups with irradiation of 500-1500 kGy had no detectable wear in this study. The original machining marks still were partially evident in the wear zones, along with some macrofissures in the 1000- and 1500-kGy cups. Areas adjacent to the fissures showed delaminating plaques of 100-300 microm in size. It also was noted that the wear cups systematically gained more weight than their corresponding soak controls. Each 200-kGy radiation gain increased the fluid sorption ratio by 10%. The increased fluid sorption and evidence of some surface deterioration may indicate that such high-dose irradiated cups are more susceptible to mechanical damage. This indicates that we should take care to ensure that our desire to reduce the wear debris to a zero amount does not result in a modified UHMWPE that lacks the necessary mechanical properties for contemporary metal-backed cup designs.

Absorption↗

PubMed2003

Wear mode and wear mechanism of retrieved acetabular cups.

Nineteen ultra-high-molecular-weighted polyethylene (UHMWPE) cups were retrieved at revision surgery. The implant period was on average 9.9 (0.25-20.7) years. The cups were classified into the high-wear group (wear rate above 140 mm(3)/year), intermediate-wear group (wear rate 80-140 mm(3)/year) and low-wear group (wear rate below 80 mm(3)/year). The wear rate was measured by a fluid displacement method. The cups were studied using scanning electron microscopy. Ripples mainly appeared on the cups in the low-wear group, and nodules and fibrils mainly appeared in the high-wear group. Folding was observed in all cups, but folding with numerous fibrils was conspicuous in the high-wear group. The cup retrieved at 3 months already exhibited folding. From these results, the wear response appeared to be a three-step process: (1) foldings are generated, (2) ripples are formed on the surface, and (3) fibrils are produced from the surface and delaminated, leading to the formation of wear debris.

Adult↗

PubMed2003

Validation of acetabular cup wear volume based on direct and two-dimensional measurements: hip simulator analysis.

The volumetric wear in retrieved cups can be assessed by mathematical conversion based on linear measurements and by a fluid-displacement method. We used a hip simulator model to produce wear in 22-, 28-, and 32-mm hip implants and then assessed the volumetric wear using a gravimetric wear method. We then compared the findings with those obtained with the linear and fluid-displacement methods. For the linear method, we translated the linear wear to the volumetric wear using the equations developed by Charnley et al., Kabo et al., and Hashimoto et al. The fluid-displacement method showed the strongest correlation with the gravimetric wear method, and it was found to overestimate the volume slightly (by 3%-9%). According to the linear wear conversion, however, the equation by Kabo widely underestimated the volume by 33%-40%. The equation used by Charnley tended to overestimate the volume (by 4%-17%), whereas Hashimoto's equation tended to slightly underestimate the volume (by 2%-12%). The fluid-displacement method demonstrated an average error of 0.34% +/- 13.40% when the wear exceeded 400 mm(3). The linear wear was thus converted to the volume wear most accurately using Hashimoto's equation, with the average error being -3.8% +/- 14.0%. Of the four measurement modalities, the fluid-displacement method showed the most accurate results. We therefore confirmed that the fluid-displacement method is the most accurate way to determine volumetric wear in retrieved cups.

Acetabulum↗

PubMed2002

Micro-wear patterns on UHMWPE tibial inserts in total knee joint simulation.

The objective of this study was to examine both simulator and retrieved total knee replacement polyethylene inserts to confirm, using scanning electron microscopy, whether similar micro-wear patterns to those seen on retrieved inserts were reproduced on simulator specimens. The simulator specimens consisted of samples subjected to sliding and rolling movement (Experiment 1) and to sliding movement only (Experiment 2). Samples from Experiment 1 demonstrated longitudinal patterns in the middle of the wear track and transverse patterns in the anterior and posterior ends, whereas in Experiment 2, only transverse patterns were observed. In the retrieved specimens, both longitudinal and transverse patterns were observed. The results showed that the simulator study reproduced similar patterns of micro-damage on polyethylene, and that the longitudinal micro-wear pattern was related to the rolling movement that is distinctive in knee kinematics.

Biomechanical Phenomena↗