Biomedical subjects

L Pruitt

Publications and source records attributed to L Pruitt.

At least 19 recordsLinked to original sources

PubMed2003

The effects of degree of crosslinking on the fatigue crack initiation and propagation resistance of orthopedic-grade polyethylene.

Crosslinked ultrahigh molecular weight polyethylene (UHMWPE) has been recently approved by the Food and Drug Administration for use in orthopedic implants. The majority of commercially available UHMWPE orthopedic components are crosslinked using e-beam or gamma radiation. The level of crosslinking is controlled with radiation dose and free radicals are eliminated through heat treatments to prevent long-term degradation associated with chain scission or oxidation mechanisms. Laboratory studies have demonstrated a substantial improvement in the wear resistance of crosslinked UHMWPE. However, a concern about the resistance to fatigue damage remains in the clinical community, especially for tibial components that sustain high cyclic contact stresses. The objective of this study was to investigate both the initiation and propagation aspects of fatigue cracks in radiation crosslinked medical-grade UHMWPE. This work evaluated three levels of radiation, which induced three crosslink densities, on the fatigue crack propagation and total fatigue life behavior. Both as-received UHMWPE, as well as those that underwent an identical thermal history as the crosslinked UHMWPE were used as controls. Fractured crack propagation specimens were examined using scanning electron microscopy to elucidate fatigue fracture mechanisms. The results of this work indicated that a low crosslink density may optimize the fatigue resistance from both a crack initiation and propagation standpoint.

Acrylic Resins↗

PubMed2003

Biochemical characterization of atherosclerotic plaque constituents using FTIR spectroscopy and histology.

The behavior of vulnerable atherosclerotic plaques is believed to be closely related to plaque composition. There is a need for an effective in vivo technique for examining plaque constituent properties. In this study, Fourier transform infrared spectroscopy using attenuated total reflectance (FTIR-ATR) was used to assess and analyze the biochemical properties of human atherosclerotic plaques. FTIR spectra clearly revealed prominent spectral features corresponding to plaque constituents of interest: the 2930 cm(-1) and 2850 cm(-1) peaks (indicating the presence of lipids), the 1730 cm(-1) peak (lipid esters), the 1550 cm(-1) and 1650 cm(-1) peaks (fibrous tissues), and the 1100-1000 cm(-1) broad phosphate peak (calcification). Spectral data examined on a qualitative basis correlated well with both gross tissue anatomy and histologic features. Gross spatial mappings of tissue sections of both lipidic and calcified plaques were performed. Spectra from various regions of the plaques demonstrated the evolution of lipid peaks, fibrous tissue peaks, and the phosphate calcification band within the plaques. Histologic analysis corroborated the spectral findings in this study.

Arteriosclerosis↗

PubMed2002

Mechanical and chemical characteristics of mineral produced by basic fibroblast growth factor-treated bone marrow stromal cells in vitro.

It has been shown that various organ and cell cultures exhibit increased mineral formation with the addition of basic fibroblast growth factor (bFGF) and phosphate ions in the medium. However, to date there has been no attempt to relate the chemical composition of mineral formed in vitro to a measure of its mechanical properties. This information is important for understanding the in vivo mineralization process, the development of in vitro models, and the design of tissue-engineered bone substitutes. In this study we examined the reduced modulus; hardness; and mineral-to-matrix, crystallinity, carbonate-to-mineral, and calcium-to-phosphorus ratios of mineral formed by bFGF-treated rat-derived bone marrow stromal cells in vitro. The cells were treated with 1 or 3 mM beta-glycerophosphate for 3 and 4 weeks. Both mechanical parameters, reduced modulus and hardness, increased with increasing beta-glycerophosphate concentration. The only chemical measure of the mineral composition that exhibited the same dependency was the mineral-to-matrix ratio. The values of crystallinity and carbonate fraction were similar to those for intact cortical bone, but the calcium-to-phosphorus ratio was substantially lower than that of normal bone. These data indicate that the mineral formed by bFGF-treated bone cells is mechanically and chemically different from naturally formed lamellar bone tissue after 4 weeks in culture. These results can be used to improve in vitro models of mineral formation as well as enhance the design of tissue-engineered bone substitutes.

Animals↗

PubMed2001

Comparison of three joint simulator wear debris isolation techniques: acid digestion, base digestion, and enzyme cleavage.

Quantification of ultrahigh molecular weight polyethylene (UHMWPE) wear debris remains a challenging task in orthopedic device analysis. Currently, the weight loss method is the only accepted practice for quantifying the amount of wear generated from a PE component. This technique utilizes loaded soak controls and weight differences to account for polymeric material lost through wear mechanisms. This method enables the determination of the amount of wear in the orthopedic device, but it provides no information about debris particulate size distribution. In order to shed light on wear mechanisms, information about the wear debris and its size distribution is necessary. To date, particulate isolation has been performed using the base digestion technique. The method uses a strong base, ultracentrifugation, and filtration to digest serum constituents and to isolate PE debris from sera. It should be noted that particulate isolation methods provide valuable information about particulate size distribution and may elucidate the mechanisms of wear associated with polymeric orthopedic implants; however, these techniques do not yet provide a direct measure of the amount of wear. The aim of this study is to present alternative approaches to wear particle isolation for analysis of polymer wear in total joint replacements without recourse to ultracentrifugation. Three polymer wear debris isolation techniques (the base method, an acid treatment, and an enzymatic digestion technique) are compared for effectiveness in simulator studies. A requirement of each technique is that the wear particulate must be completely devoid of serum proteins in order to effectively image and count these particles. In all methods the isolation is performed through filtration and chemical treatment. Subsequently, the isolated polymer particles are imaged using scanning electron microscopy and quantified with digital image analysis. The results from this study clearly show that isolation can be performed without the use of ultracentrifugation and that these methods provide a viable option for wear debris analysis.

Biocompatible Materials↗

PubMed2001

Chemical and biological characteristics of low-temperature plasma treated ultra-high molecular weight polyethylene for biomedical applications.

Several low-temperature radio-frequency (RF) plasma surface treatments were performed on ultra-high molecular weight polyethylene (UHMWPE) used in biomedical applications. Process gases included Ar, C3F6, CH4, hexamethyldisiloxane (HMDSO), and NH4. These treatments were carried out at pressures in the range of 64-400 mTorr, RF powers of 240-1200 W, and temperatures well below the melting point of UHMWPE. X-ray photoelectron spectroscopy (XPS) was used to obtain information about the surface characteristics of UHMWPE treated with the HMDSO, C3F6, and CH4 gases as a function of treatment conditions. XPS spectra of UHMWPE treated with C3F6 and CH4 and exposed to a laboratory environment for different time periods were examined in order to assess the stability of these treatments. It was found that for the C3F6 process gas the amount of fluorine at the surface decreased over time, whereas the oxygen content of the CH4 treated samples increased as a function of time. In vitro cytotoxicity of Ar, C3F6, CH4, and NH4 plasma treated samples was studied in light of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) test results. The hemolytic nature of the various plasma treatments was evaluated using standard hemolysis tests. All of the samples tested in this study exhibited no cytotoxic and negligible hemolytic effects. The process parameters for several low-temperature plasma treatments demonstrating chemical and structural stability and good biocompatibility are discussed in conjunction with the broad applicability to other biomedical polymers.

Journal Article↗

PubMed2000

Fluid sorption of orthopedic grade ultrahigh molecular weight polyethylene in a serum environment is affected by the surface area and sterilization method.

It is shown in this work that lubricant sorption in ultrahigh molecular weight polyethylene (UHMWPE) increases with available surface area of the component. This has clinical relevance, because sliding and articulation experienced in simulator studies can result in changes in surface roughness and the creation of new surfaces. This study compares the fluid sorption of orthopedic grade UHMWPE with different surface areas (but equivalent volume) for different sterilization methods. For both the gamma radiation and nonsterile control samples, the gain in total fluid absorbed scaled proportionately with surface area. For the EtO sterilization treatment, the fluid gain was nonlinear and substantially less than the radiated and control groups. The findings from this study clearly indicate that the sterilization and surface area affect the fluid uptake and weight gain of UHMWPE.

Adsorption↗

PubMed2000

Characteristics of inactive primary care patients: baseline data from the activity counseling trial. For the Activity Counseling Trial Research Group.

BACKGROUND: Although many primary care patients are inactive, being able to classify even small amounts and intensities of activity and factors associated with these activity levels could be helpful for physicians who are trying to motivate their patients to become more physically active. METHODS: Sociodemographics, physical activity, fitness, other cardiovascular risk factors, and psychosocial measures were measured at baseline in the 874 patients in the Activity Counseling Trial. Patients were categorized into three groups: (1) no moderate-to-vigorous physical activity (MVPA), (2) some moderate but no vigorous activity, and (3) some vigorous activity. Multiple logistic regression was used to determine factors cross-sectionally associated with activity intensity. RESULTS: One or more cardiovascular risk factors in addition to physical inactivity were present in 84% of participants. Maximal oxygen uptake averaged 25.2 ml/kg/min; 85% had poor to fair aerobic fitness. Physical activity averaged 32.7 kcal/kg/day, with 13.5 min of MVPA/day; 26% engaged in some vigorous activity, 11% engaged in no MVPA. In unadjusted analyses, gender, age, race, education, income, employment, smoking, alcohol use, and exercise self-efficacy were associated with activity intensity (P = 0.05-0.001). A greater percentage engaged in moderate than in vigorous activity in all subgroups. In multiple logistic regression analyses, odds ratios (95% confidence intervals) for engaging in vigorous activity were 0. 39 (0.28, 0.56) for women, 0.38 (0.19, 0.75) for 65+ compared with 35- to 44-year-olds, and 1.14 (1.06, 1.22) for 10-unit increases in performance self-efficacy score. CONCLUSIONS: Most primary care patients who are physically inactive have additional cardiovascular risk factors, particularly overweight and obesity. All subgroups pursue moderate-intensity activity more often than vigorous activity. Women, older persons, and those with lower exercise self-efficacy are less likely to engage in vigorous activity.

Adult↗

PubMed2000

The relationship between the clinical performance and large deformation mechanical behavior of retrieved UHMWPE tibial inserts.

Many aspects of the proposed relationship between material properties and clinical performance of UHMWPE components remain unclear. In this study, we explored the hypothesis that the clinical performance of tibial inserts is directly related to its large-deformation mechanical behavior measured near the articulating surface. Retrieval analysis was performed on three conventional UHMWPE and three Hylamer-M tibial components of the same design and manufacturer. Samples of material were then obtained from the worn regions of each implant and subjected to mechanical characterization using the small punch test. Statistically significant relationships were observed between the metrics of the small punch test and the total damage score and the burnishing damage score of the implants. We also examined the near-surface morphology of the retrievals using transmission electron microscopy. TEM analysis revealed lamellar alignment at and below the wear surfaces of the conventional UHMWPE retrievals up to a maximum depth of approximately 8 microm, consistent with large-deformation crystalline plasticity. The depth of the plasticity-induced damage layer varied not only between the retrievals, but also between the conventional UHMWPE and Hylamer-M components. Thus, the results of this study support the hypothesis that the clinical performance of UHMWPE tibial inserts is related to the large-deformation mechanical behavior measured near the articulating surface.

Biocompatible Materials↗

PubMed2000

Fracture and fatigue properties of acrylic bone cement: the effects of mixing method, sterilization treatment, and molecular weight.

The purpose of this study was to characterize the relative and combined effects of sterilization, molecular weight, and mixing method on the fracture and fatigue performance of acrylic bone cement. Palacos R brand bone cement powder was sterilized using ethylene oxide gas (EtO) or gamma irradiation. Nonsterile material was used as a control. Molecular weights of the bone-cement powders and cured cements were measured using gel permeation chromatography. Hand and vacuum mixing were employed to mold single edge-notched bend specimens for fracture toughness testing. Molded dog-bone specimens were used for fatigue tests. Electron microscopy was used to study fracture mechanisms. Analysis of variance and Student t-tests were used to compare fracture and fatigue performance between sterilization and mixing groups. Our results indicate that vacuum mixing improved significantly the fracture and fatigue resistance (P<.05, P<.07) over hand mixing in radiation-sterilized and EtO-sterilized groups. In vacuum-mixed cement, the degradation in molecular weight resulting from gamma irradiation decreased fracture resistance significantly when compared with EtO sterilization and control (P<.05). A corresponding decrease in fatigue resistance was observed in the cement that was degraded severely by a radiation dose of 10 MRad (P<.05). In contrast, EtO sterilization did not result in a significantly different fracture resistance when compared with unsterilized controls for vacuum-mixed cement (P>.1). For hand-mixed cement, fracture and fatigue resistance appeared to be independent of sterilization method. This independence is believed to be the result of higher porosity that compromised the mechanical properties and obscures any effect of sterilization. Our results indicate that a combination of nonionizing sterilization and vacuum mixing resulted in the best mechanical performance and is most likely to contribute to enhanced longevity in vivo.

Animals↗

PubMed1999

Study of fatigue resistance of chemical and radiation crosslinked medical grade ultrahigh molecular weight polyethylene.

The aim of this work is to understand the role of chemical and radiation induced crosslinking on the fatigue crack propagation resistance of medical grade ultrahigh molecular weight polyethylene (UHMWPE). In recent years, the need to improve the tribological performance of UHMWPE used in total joint replacements has resulted in the widespread utilization of crosslinking as a method to improve wear resistance. Although crosslinking has been shown to drastically improve the wear resistance of the polymer, the potential trade-off in fatigue properties has yet to be addressed. Fatigue crack propagation resistance is a concern in tibial inserts where large cyclic stresses are sufficient to drive the growth of subsurface cracks that potentially contribute to delamination wear mechanisms. For clinical relevance, the combined effects of sterilization and aging are examined in two commercially available crosslinked resins. Nonsterile and unaged resins serve as a control. To evaluate the effect of crosslinking, a comparison is made to uncrosslinked resins. Scanning electron microscopy is used to provide an understanding of fatigue fracture mechanisms in the crosslinked polymers. The results of this study show that the current level of crosslinking used in orthopedic resins for enhanced wear resistance is not beneficial for fatigue crack propagation resistance.

Biocompatible Materials↗

PubMed1999

Mechanical properties of medical grade expanded polytetrafluoroethylene: the effects of internodal distance, density, and displacement rate.

Expanded polytetrafluoroethylene (e-PTFE) is used successfully in a multitude of biomedical and clinical applications. The success of this biomaterial is due to its microporous structure that allows biointegration for fixation, as well as overall mechanical integrity. The mechanical properties and degree of tissue ingrowth depend on the microstructure of the expanded polymer foam, yet little is known about the correlation of the internodal distance and other microstructural features with the monotonic tensile properties. Complete structure-property correlation can be used to provide invaluable knowledge for the design of biomedical devices. The purpose of this study was to investigate the monotonic tensile properties of e-PTFE over a range of medically relevant microstructural features and manufacturing parameters. The microstructural and manufacturing parameters considered were internodal distance, linear density, volumetric density, and reduction ratio. Additionally, the effect of displacement rate on mechanical properties was studied. We found that the ultimate stress and strain increased linearly with linear density (R2 = 0.88 and 0.67, respectively). Surprisingly, elastic modulus did not correlate with any parameter measured and only weak correlations were found between all properties and internodal distance. The yield and ultimate stresses increased with increasing displacement rate (R2 = 0.88 and 0.57, respectively). The findings from this study indicate that linear density is a better predictor of mechanical properties than internodal distance and may be the preferred parameter to control when specifying a material for implantation in load bearing situations.

Biocompatible Materials↗

PubMed1999

Failure of a metal-on-metal total hip arthroplasty from progressive osteolysis.

Ultra-high-molecular weight polyethylene (UHMWPE) wear, debris-induced osteolysis is a frequent cause of failure of total hip arthroplasty. Metal-on-metal total hip arthroplasty eliminates the generation of UHMWPE particulate debris. Although the volumetric wear of a metal-on-metal articulation may be lower than a metal-UHMWPE articulation, the number of particles may be higher. Osteolysis can develop in response to metallic and UHMWPE debris. The following case of massive osteolysis associated with large amounts of cobalt-chrome wear debris shows adhesive and abrasive wear mechanisms, as well as wear caused by third-body cobalt-chrome debris and impingement of the femoral component against the rim of the acetabular cup, which led to failure of a metal-on-metal total hip arthroplasty.

Aged↗

PubMed1999

Plasticity-induced damage layer is a precursor to wear in radiation-cross-linked UHMWPE acetabular components for total hip replacement. Ultra-high-molecular-weight polyethylene.

The mechanism for the improved wear resistance of cross-linked ultra-high-molecular-weight polyethylene (UHMWPE) remains unclear. This study investigated the effect of cross-linking achieved by gamma irradiation in nitrogen on the tribologic, mechanical, and morphologic properties of UHMWPE. The goal of this study was to relate UHMWPE properties to the wear mechanism in acetabular-bearing inserts. Wear simulation of acetabular liners was followed by detailed characterization of the mechanical behavior and crystalline morphology at the articulating surface. The wear rate was determined to be directly related to the ductility, toughness, and strain-hardening behavior of the UHMWPE. The concept of a plasticity-induced damage layer is introduced to explain the near-surface orientation of the crystalline lamellae observed in the wear-tested acetabular liners. Cross-linking reduces abrasive wear of acetabular components by substantially reducing--but not eliminating--the plasticity-induced damage layer that precedes abrasive wear.

Acetabulum↗

PubMed1999

Diamond-like carbon coatings for orthopaedic applications: an evaluation of tribological performance.

A detailed investigation of the tribological behaviour of vacuum arc diamond-like carbon coated Ti-6Al-4V against a medical grade ultra-high molecular weight polyethylene is conducted in this work in order to investigate the potential use of diamond-like carbon coatings for orthopaedic appplications. Lubricated and non-lubricated wear experiments are performed using a standard pin-on-disc wear tester. The coefficient of friction is monitored continuously during testing and wear rate calculations are performed using surface profilometry measurements of worn disc surfaces. Sliding wear tests show the existence of two distinct friction and wear regimes distinguished by physically different mechanisms. In the first stages of wear, adhesion and abrasion are the dominant mechanisms of wear while fatigue processes are activated later in the tests. The effects of diamond-like carbon coating structure, surface roughness and lubrication on tribological behaviour are presented. Optimal process-structure-property design for vacuum arc plasma deposition is utilized in order to obtain strong adhesion to the titanium alloy substrate. Diamond-like carbon coatings significantly improve the friction and wear performance of the orthopaedic bearing pair and show exceptional promise for biomedical applications.

Journal Article↗

PubMed1998

Comparison of the effects of gamma radiation and low temperature hydrogen peroxide gas plasma sterilization on the molecular structure, fatigue resistance, and wear behavior of UHMWPE.

The effects of gamma radiation and low temperature hydrogen peroxide gas plasma (HPGP) sterilization on structure and cyclic mechanical properties were examined for orthopedic grade ultra-high-molecular-weight polyethylene (UHMWPE) and compared to each other as well as to no sterilization (control). Density was monitored with a density gradient column and was found to be directly influenced by the sterilization method employed: Gamma radiation led to an increase, while plasma did not. Oxidation of the polymer was studied by observing changes in the carbonyl peak with Fourier transform infrared spectrometry and was found to be strongly affected by both gamma radiation and subsequent aging, while plasma sterilization had little effect. Gamma radiation resulted in embrittlement of the polymer and a decreased resistance to fatigue crack propagation. This mechanical degradation was a direct consequence of postradiation oxidation and molecular evolution of the polymer and was not observed in the plasma-sterilized polymer. Both gamma radiation and plasma sterilization led to improved wear performance of the UHMWPE compared to the nonsterile control material.

Cold Temperature↗

PubMed1998

The yielding, plastic flow, and fracture behavior of ultra-high molecular weight polyethylene used in total joint replacements.

The yielding, plastic flow, and fracture behavior of UHMWPE plays an important role in wear and failure mechanisms of total joint replacement components. The primary objective of this study was to compare the yielding, plastic flow, and fracture behavior of two implantable grades of UHMWPE (GUR 1120 vs 4150 HP). The first part of this work explored the hypothesis that up to the polymer yield point, the monotonic loading behavior of UHMWPE displays similar true stress strain behavior in tension and compression. Uniaxial tension and compression tests were conducted to compare the equivalent true stress vs strain response of UHMWPE up to 0.12 true strain. During monotonic loading, the equivalent true stress strain behavior was similar in tension and compression up to the yield point. However, investigation of the unloading behavior and permanent plastic deformations showed that classical deviatoric rate independent plasticity theory may dramatically overpredict the permanent strains in UHMWPE. A secondary goal of this study was to determine the ultimate true stress and strain for UHMWPE and to characterize the fracture surfaces after failure. Using a fracture mechanics approach, the critical flaw sizes were used in combination with the true ultimate stresses to predict the fracture toughness of the two resins. A custom video-based strain measurement system was developed and validated to characterize the true stress-strain behavior up to failure and to verify the accuracy of the incompressibility assumption in calculating the true stress-strains up to failure. In a detailed uncertainty analysis, theoretical expressions were derived for the relative uncertainty in digital video-based estimates of nominal strain, true strain, homogeneous stress, and true stress. Although the yielding behavior of the two UHMWPE resins was similar, the hardening and plastic flow behavior clearly discriminated between the GUR 1120 and 4150 HP. A statistically significant difference between the fracture toughness of the two resins was also evident. The long-term goal of this research is to provide detailed true stress strain data for UHMWPE under uniaxial tension and compression for future numerical simulations and comparison with more complex multiaxial loading conditions.

Biocompatible Materials↗

PubMed1998

The influence of sterilization technique and ageing on the structure and morphology of medical-grade ultrahigh molecular weight polyethylene.

The effects of four sterilization treatments (gamma radiation in nitrogen, electron-beam radiation, ethylene oxide gas, and no sterilization) on the structure and morphology of ultrahigh molecular weight polyethylene (UHMWPE) were monitored as a function of ageing time in air for a period of 1.5 y. Characterization techniques employed include differential scanning calorimetry, density gradient column, transmission electron microscopy, and small-angle X-ray scattering. Ethylene oxide gas does not affect the structure of the polymer. Both forms of radiation lead to measurable alterations of the material's structure, including an increase in crystallinity, an increase in density, and the enhancement of lamellae crystalline stacking. Most changes in structure occur in the first few months with little differences observed upon subsequent ageing in air. The sharpness of the crystalline-amorphous boundaries decreases with time for irradiated UHMWPE and is believed to be linked to the oxidation of the polymer.

Journal Article↗

PubMed1997

Oxidation of ultrahigh molecular weight polyethylene characterized by Fourier Transform Infrared Spectrometry.

The effects of processing conditions, sterilization treatment, aging time, and poststerilization aging environment on the oxidation behavior of ultrahigh molecular weight polyethylene (UHMWPE) are examined. Oxidation is monitored by observing changes in the carbonyl peak appearing in Fourier Transform Infrared Spectrometry (FTIR) and is found to be relatively insensitive to processing conditions but strongly influenced by sterilization treatments and aging parameters. Oxygen uptake by UHMWPE increases as a result of gamma or electron beam irradiation and continues to rise during subsequent aging at a rate influenced by the aging environment. A hydrogen peroxide ambient causes more severe oxidation than either air or hyaluronic acid. Control (unsterilized) samples and those sterilized in ethylene oxide are resistant to oxidation under all conditions except hydrogen peroxide aging.

Biocompatible Materials↗