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Biomedical subjects

Z M Jin

Publications and source records attributed to Z M Jin.

At least 19 recordsLinked to original sources

A simple fully integrated contact-coupled wear prediction for ultra-high molecular weight polyethylene hip implants.

A fully coupled contact and wear model was developed in the present study for hip implants employing an ultra-high molecular weight polyethylene (UHMWPE) cup in combination with a metallic or ceramic femoral head. A simple elasticity equation based on the concept of constrained column model was employed to solve the contact mechanics between the acetabular cup and the femoral head under the three-dimensional physiological loading condition. The wear model was based on the classical Archard-Lancaster equation in common with all other studies reported in the literature. The fully coupled contact and wear model was applied to both conventional and cross-linked UHMWPE cups under a wide range of design parameters such as the clearance and the femoral head radius. The predicted linear and volumetric wear as well as their rates for conventional UHMWPE cups were found to be in good agreement with those obtained from a similar analysis by Maxian but using the finite element method for the contact mechanics analysis. The predicted maximum contact pressure was found to decrease rapidly within the first 10(6) cycles, and below the limit to cause plastic deformation within the UHMWPE cup with a nominal radial clearance of 0.2 mm. The effect of the clearance between the head and the cup on the predicted wear was found to be negligible. For the cross-linked UHMWPE cup with relatively large diameters up to 48 mm and a fixed outside diameter of 50 mm, the predicted wear, which was found to increase with increasing femoral head radius, remained small owing to the small wear factor associated with these materials. Furthermore, if the head diameter increases beyond 42 mm, a rapid increase in the contact pressure was predicted, owing to the decrease in the wall thickness of the cross-linked UHMWPE cup.

Animals↗

Deformation of press-fitted metallic resurfacing cups. Part 2: Finite element simulation.

The deformation of metallic acetabular cups employed for metal-on-metal hip resurfacing procedures was considered theoretically using the finite element method in the present study, following on the experimental investigation reported in Part 1. Three representative cups, characterized by the cup wall thickness as thin, intermediate, and thick, were considered. For the intermediate cup, the effects of both the size and the diametral interference on the cup deformation were investigated. Both two-dimensional axisymmetric and three-dimensional finite element models were developed to examine the important parameters during and after the press-fit procedure, and in particular the deformation of the metallic cup. The theoretical prediction of the cup deformation was in reasonable agreement with the corresponding experimental measurement reported in Part 1. The most significant factor influencing the cup deformation was the cup wall thickness. Both the size and the diametral interference were also shown to influence the cup deformation. It is important to ensure that the cup deformation does not significantly affect the clearance designed and optimized for tribological performances of metal-on-metal hip resurfacing prostheses. Furthermore the contact parameters at the cup and bone interface associated with the press fit were also discussed.

Acetabulum↗

Metal-on-metal hip joint tribology.

The basic tribological features of metal-on-metal total hip replacements have been reviewed to facilitate an understanding of the engineering science underpinning the renaissance of these hard-on-hard joints. Metal-on-polymer hip replacements operate in the boundary lubrication regime, thus leading to the design guidance to reduce the femoral head diameter as much as is feasible to minimize frictional torque and volumetric wear. This explains why the gold-standard implant of this form from the past half-century had a diameter of only 22.225 mm (7/8 in). Metal-on-metal implants can operate in the mild mixed lubrication regime in which much of the applied load is supported by elastohydrodynamic films. Correct tribological design leads to remarkably low steady state wear rates. Promotion of the most effective elastohydrodynamic films calls for the largest possible head diameters and the smallest clearances that can reasonably be adopted, consistent with fine surface finishes, good sphericity and minimal structural elastic deformation of the cup on its foundations. This guidance, which is opposite in form to that developed for metal-on-polymer joints, is equally valid for solid (monolithic) metallic heads on metallic femoral stems and surface replacement femoral shells. Laboratory measurements of friction and wear in metal-on-metal joints have confirmed their potential to achieve a very mild form of mixed lubrication. The key lies in the generation of effective elastohydrodynamic lubricating films of adequate thickness compared with the composite roughness of the head and cup. The calculation of the film thickness is by no means easy, but the full procedure is outlined and the use of an empirical formula that displays good agreement with calculations based upon the full numerical solutions is explained. The representation of the lambda ratio, lambda, embracing both film thickness and composite roughness, is described.

Arthroplasty, Replacement, Hip↗

Effect of ultra-high molecular weight polyethylene thickness on contact mechanics in total knee replacement.

One of the important design parameters in current knee joint replacements is the thickness of the ultra-high molecular weight polyethylene (UHMWPE) tibial insert, yet there is no clear definition of the upper limit of the 'thick' polyethylene insert. Using one design knee implant and subjecting it to the physiological loads encountered throughout the gait cycle, measurements of the lengths of contact imprints generated were compared with the corresponding theoretical predictions for different insert thicknesses under the same applied load. Multiple regression analysis was applied to test whether the dimensions of contact imprints are influenced by UHMWPE thickness. Good agreement was obtained between the theoretical predictions and the experimental measurements of the dimensions of contact imprints when the knee was at 60 degrees flexion. Therefore, it was possible to estimate the contact pressure at the articulating surface using the theoretical model. Contact imprint dimensions increased with increasing applied load. Statistical analysis of the experimental data revealed that, at 0 degree flexion, the overall imprint dimensions increased as the UHMWPE thickness increased from 8 to 20 mm. However, the increment was not significant when the thickness subinterval 10-15 mm was considered. Furthermore, at 60 degrees flexion, thickness was not a significant factor for the overall imprint dimensions. No evidence was found from the data to suggest that an increment in polyethylene thickness over 10 mm would significantly reduce the contact imprint dimensions. These findings suggest that thicker inserts can be avoided, as they require unnecessary bone resection.

Acetabulum↗

Transient elastohydrodynamic lubrication analysis of metal-on-metal hip implant under simulated walking conditions.

The transient elastohydrodynamic lubrication (EHL) analysis was performed in this study for a typical metal-on-metal bearing employing a polyethylene backing underneath a metallic cup inlay under dynamic operating conditions of load and speed representative of normal walking. A ball-in-socket configuration was adopted to represent the articulation between the femoral head and the acetabular cup. The governing Reynolds and elasticity equations were solved simultaneously by using both finite difference and finite element methods. The predicted transient film thickness from the present study was compared with the estimation based on the quasi-static analysis. It was found that the polyethylene backing employed in the typical metal-on-metal hip bearing, combined with dynamic squeeze-film action, significantly improved the transient lubricant film thickness under cyclic walking and consequently a fluid film lubrication regime was possible for smooth bearing surfaces with an average roughness less than 0.005 microm.

Biocompatible Materials↗

Effect of wear of bearing surfaces on elastohydrodynamic lubrication of metal-on-metal hip implants.

The effect of geometry change of the bearing surfaces owing to wear on the elastohydrodynamic lubrication (EHL) of metal-on-metal (MOM) hip bearings has been investigated theoretically in the present study. A particular MOM Metasul bearing (Zimmer GmbH) was considered, and was tested in a hip simulator using diluted bovine serum. The geometry of the worn bearing surface was measured using a coordinate measuring machine (CMM) and was modelled theoretically on the assumption of spherical geometries determined from the maximum linear wear depth and the angle of the worn region. Both the CMM measurement and the theoretical calculation were directly incorporated into the elastohydrodynamic lubrication analysis. It was found that the geometry of the original machined bearing surfaces, particularly of the femoral head with its out-of-roundness, could lead to a large reduction in the predicted lubricant film thickness and an increase in pressure. However, these non-spherical deviations can be expected to be smoothed out quickly during the initial running-in period. For a given worn bearing surface, the predicted lubricant film thickness and pressure distribution, based on CMM measurement, were found to be in good overall agreement with those obtained with the theoretical model based on the maximum linear wear depth and the angle of the worn region. The gradual increase in linear wear during the running-in period resulted in an improvement in the conformity and consequently an increase in the predicted lubricant film thickness and a decrease in the pressure. For the Metasul bearing tested in an AMTI hip simulator, a maximum total linear wear depth of approximately 13 microm was measured after 1 million cycles and remained unchanged up to 5 million cycles. This resulted in a threefold increase in the predicted average lubricant film thickness. Consequently, it was possible for the Metasul bearing to achieve a fluid film lubrication regime during this period, and this was consistent with the minimal wear observed between 1 and 5 million cycles. However, under adverse in vivo conditions associated with start-up and stopping and depleted lubrication, wear of the bearing surfaces can still occur. An increase in the wear depth beyond a certain limit was shown to lead to the constriction of the lubricant film around the edge of the contact conjunction and consequently to a decrease in the lubricant film thickness. Continuous cycles of a running-in wear period followed by a steady state wear period may be inevitable in MOM hip implants. This highlights the importance of minimizing the wear in these devices during the initial running-in period, particularly from design and manufacturing points of view.

Biocompatible Materials↗

Steady-state elastohydrodynamic lubrication analysis of a metal-on-metal hip implant employing a metallic cup with an ultra-high molecular weight polyethylene backing.

The elastohydrodynamic lubrication (EHL) analysis was carried out in this study for a 28 mm diameter metal-on-metal hip prosthesis employing a metallic cup with an ultra-high molecular weight polyethylene (UHMWPE) backing under a simple steady state rotation representing the flexion/extension during walking. Both Reynolds and elasticity equations were coupled and solved numerically by the finite difference method. The elastic deformation was determined by means of the fast Fourier transform (FFT) technique using the displacement coefficients obtained from the finite element method. Excellent agreement of the predicted elastic deformation was obtained between the FFT technique and the conventional direct summation method. The number of grid points used in the lubrication analysis was found to be important in predicting accurate film thicknesses, particularly at low viscosities representative of physiological lubricants. The effect of the clearance between the femoral head and the acetabular cup on the predicted lubricant film thickness was shown to be significant, while the effect of load was found to be negligible. Overall, the UHMWPE backing was found not only to reduce the contact pressure as identified in a previous study by the authors (Liu et al., 2003) but also significantly to increase the lubricant film thickness for the 28 mm diameter metal-on-metal hip implant, as compared with a metallic mono-block cup.

Computer Simulation↗

A general elastohydrodynamic lubrication analysis of artificial hip joints employing a compliant layered socket under steady state rotation.

A general numerical methodology was developed in the present study to analyse the elastohydrodynamic lubrication problem of a compliant layered socket against a rigid ball under steady state rotation representing flexion and extension during walking, with particular reference to artificial hip joint replacements. The general numerical methodology consisted of using the Newton-Raphson method to solve the Reynolds equation, simultaneously with the full elasticity equation using the finite element method in combination with the fast Fourier transform technique. Two specific types of acetabular cup were considered, one with ultra-high molecular weight polyethylene used in current total hip joint replacements, and one with polyurethane proposed for compliant layered 'cushion form bearings' for future developments. The film thickness and the pressure distribution for both cups were obtained under a wide range of operating conditions. The predicted central or average film thicknesses within the contact conjunction were compared with those estimated from various simplified theories available in the literature. A simple analytical methodology was consequently established to estimate the lubricating film thickness in a compliant layered socket, based on the corresponding ball-on-plane model and the consideration of the curvature effect.

Computer Simulation↗

Contact mechanics analysis of metal-on-metal hip resurfacing prostheses.

Finite-element method was employed to study the contact mechanics in metal-on-metal hip resurfacing prostheses, with particular reference to the effects of bone quality, the fixation condition between the acetabular cup and bone, and the clearance between the femoral head and the acetabular cup. Simple finite-element bone models were developed to simulate the contact between the articulating surfaces of the femoral head and the acetabular cup. The stresses within the bone structure were also studied. It was shown that a decrease in the clearance between the acetabular cup and femoral head had the largest effect on reducing the predicted contact-pressure distribution among all the factors considered in this study. It was found that as the clearance was reduced, the influence of the underlying materials, such as bone and cement, became increasingly important. Stress shielding was determined to occur in the bone tissue surrounding the hip resurfacing prosthesis considered in this study. However, the stress-shielding effects predicted were less than those observed in conventional total hip replacements. Both the effects of bone quality (reduction in elastic modulus) and the fixation condition between the cup and the bone were found to have a negligible effect on the predicted contact mechanics at the bearing surface. The loading was found to have a relatively small effect on the predicted maximum contact pressure at the bearing surface; this was attributed to an increase in contact area as the load was increased.

Computer Simulation↗

Analysis of elastohydrodynamic lubrication in McKee-Farrar metal-on-metal hip joint replacement.

An elastohydrodynamic lubrication (EHL) analysis was carried out in this study for a typical McKee-Farrar metal-on-metal hip prosthesis under a simple steady state rotation. The finite element method was used initially to investigate the effect of the cement and bone on the predicted contact pressure distribution between the two articulating surfaces under dry conditions, and subsequently to determine the elastic deformation of both the femoral and the acetabular components required for the lubrication analysis. Both Reynolds equation and the elasticity equation were coupled and solved numerically using the finite difference method. Important features in reducing contact stresses and promoting fluid-film lubrication associated with the McKee-Farrar metal-on-metal hip implant were identified as the large femoral head and the thin acetabular cup. For the typical McKee-Farrar metal-on-metal hip prosthesis considered under typical walking conditions, an increase in the femoral head radius from 14 to 17.4 mm (for a fixed radial clearance of 79 microm) was shown to result in a 25 per cent decrease in the maximum dry contact pressure and a 60 per cent increase in the predicted minimum film thickness. Furthermore, the predicted maximum contact pressure considering both the cement and the bone was found to be decreased by about 80 per cent, while the minimum film thickness was predicted to be increased by 50 per cent. Despite a significant increase in the predicted minimum lubricating film thickness due to the large femoral head and the thin acetabular cup, a mixed lubrication regime was predicted for the McKee-Farrar metal-on-metal hip implant under estimated in vivo steady state walking conditions, depending on the surface roughness of the bearing surfaces. This clearly demonstrated the important influences of the material, design and manufacturing parameters on the tribological performance of these hard-on-hard hip prostheses. Furthermore, in the present contact mechanics analysis, the significant increase in the elasticity due to the relatively thin acetabular cup was not found to cause equatorial contact and gripping of the ball.

Acetabulum↗

Prediction of scratch resistance of cobalt chromium alloy bearing surface, articulating against ultra-high molecular weight polyethylene, due to third-body wear particles.

The entrapment of abrasive particles within the articulation between a cobalt chromium alloy (CoCrMo) femoral component and an ultra-high molecular weight polyethylene (UHMWPE) cup of artificial hip joints or tibial inserts of artificial knee joints usually scratches the metallic bearing surface and consequently increases the surface roughness. This has been recognized as one of the main causes of excessive polyethylene wear, leading to osteolysis and loosening of the prosthetic components. The purpose of this study was to use the finite element method to investigate the resistance of the cobalt chromium alloy bearing surface to plastic deformation, as a first approximation to causing scratches, due to various entrapped debris such as bone, CoCrMo and ZrO2 (contained in radiopaque polymethyl methacrylate cement). A simple axisymmetric micro contact mechanics model was developed, where a spherical third-body wear particle was indented between the two bearing surfaces, modelled as two solid cylinders of a given diameter, under the contact pressure determined from macro-models representing either hip or knee implants. The deformation of both the wear particle and the bearing surfaces was modelled and was treated as elastic-plastic. The indented peak-to-valley height on the CoCrMo bearing surface from the finite element model was found to be in good agreement with that reported in a previous study when the third-body wear particle was assumed to be rigid. Under the physiological contact pressure experienced in both hip and knee implants, ZrO2 wear particles were found to be fully embedded within the UHMWPE bearing surface, and the maximum von Mises stresses within the CoCrMo bearing surface reached the corresponding yield strength. Consequently, the CoCrMo bearing surface was deformed plastically and the corresponding peak-to-valley height (surface roughness) was found to increase with both the hardness and the size of the wear particle. Even in the case of CoCrMo wear particles, with similar mechanical properties to those of the CoCrMo bearing surface, a significant plastic deformation of the bearing surface was also noted; this highlighted the importance of considering the deformation of the wear particles. These findings support the hypotheses made by clinical studies on the contribution of entrapped debris to increased surface roughness of CoCrMo femoral bearing surfaces.

Compressive Strength↗

Elastohydrodynamic lubrication analysis of metal-on-metal hip-resurfacing prostheses.

The elastohydrodynamic lubrication analysis was carried out in this study for a typical metal-on-metal hip-resurfacing prosthesis under a simple steady-state rotation. Both the Reynolds equation and the elasticity equation were coupled and solved numerically by the finite difference method. The finite element method was used to determine the elastic deformation of both the femoral and the acetabular components required for the lubrication analysis. The effect of the radial clearance between the femoral head and the acetabular cup on the predicted film thickness and pressure distribution was investigated. The predicted minimum lubricating film thickness was found to compare favourably with the prediction using the Hamrock and Dowson [J. Lubrication Technol. 100 (1978) 236] formula based on the assumption of ball-on-plane semi-infinite solids. This implies that the non-metallic materials such as bone and cement underlying the metallic components have a small effect on the predicted lubrication performance for the particular metal-on-metal hip-resurfacing prosthesis considered in this study. Under realistic physiological walking conditions, a decrease in the radial clearance from 150 to 50 microm resulted in a 137% increase in the predicted minimum film thickness from 19 to 45 nm. Consequently, given a surface roughness of 0.01 microm for both the metallic femoral and acetabular bearing surfaces, the predicted mixed lubrication regime for the larger clearance was changed to a full fluid film lubrication regime for the smaller clearance. This clearly highlighted the importance of the design and manufacturing parameters on the tribological performance of these hard-on-hard hip prostheses.

Algorithms↗

Analysis of contact mechanics in McKee-farrar metal-on-metal hip implants.

Contact mechanics analysis for a typical McKee-Farrar metal-on-metal hip implant was carried out in this study. The finite element method was used to predict the contact area and the contact pressure distribution at the bearing surfaces. The study investigated the effects of the cement and underlying bone, the geometrical parameters such as the radial clearance between the acetabular cup and the femoral head, and the acetabular cup thickness, as well as other geometrical features on the acetabular cup such as lip and studs. For all the cases considered, the predicted contact pressure distribution was found to be significantly different from that based upon the classical Hertz contact theory, with the maximum value being away from the centre of the contact region. The lip on the cup was found to have a negligible effect on the predicted contact pressure distribution. The presence of the studs on the outside of the cup caused a significant increase in the local contact pressure distribution, and a slight decrease in the contact region. Reasonably good agreement of the predicted contact pressure distribution was found between a three-dimensional anatomical model and a simple two-dimensional axisymmetric model. The interfacial boundary condition between the acetabular cup and the underlying cement, modelled as perfectly fixed or perfectly unbonded, had a negligible effect on the predicted contact parameters. For a given radial clearance of 0.079 mm, the decrease in the thickness of the acetabular cup from 4.5 to 1.5 mm resulted in an increase in the contact half angle from 15 degrees to 26 degrees, and a decrease in the maximum contact pressure from 55 to 20 MPa. For a given acetabular cup thickness of 1.5 mm, a decrease in the radial clearance from 0.158 to 0.0395 mm led to an increase in the contact half-angle from 20 degrees to 30 degrees, and a decrease in the maximum contact pressure from 30 to 10 MPa. For zero clearance, although the contact pressure was significantly reduced over most of the contact area, the whole acetabular cup came into contact with the femoral head, leading to stress concentration at the edge of the cup. Design optimization of the geometrical parameters, in terms of the acetabular cup thickness and the radial clearance, is important, not only to minimize the contact stress at the bearing surfaces, but also to avoid equatorial and edge contact.

Acetabulum↗

Microscopic asperity contact and deformation of ultrahigh molecular weight polyethylene bearing surfaces.

The effect of the roughness and topography of ultrahigh molecular weight polyethylene (UHMWPE) bearing surfaces on the microscopic contact mechanics with a metallic counterface was investigated in the present study. Both simple sinusoidal roughness forms, with a wide range of amplitudes and wavelengths, and real surface topographies, measured before and after wear testing in a simple pin-on-plate machine, were considered in the theoretical analysis. The finite difference method was used to solve the microscopic contact between the rough UHMWPE bearing surface and a smooth hard counterface. The fast Fourier transform (FFT) was used to cope with the large number of mesh points required to represent the surface topography of the UHMWPE bearing surface. It was found that only isolated asperity contacts occurred under physiological loading, and the real contact area was only a small fraction of the nominal contact area. Consequently, the average contact pressure experienced at the articulating surfaces was significantly higher than the nominal contact pressure. Furthermore, it was shown that the majority of asperities on the worn UHMWPE pin were deformed in the elastic region, and consideration of the plastic deformation only resulted in a negligible increase in the predicted asperity contact area. Microscopic asperity contact and deformation mechanisms may play an important role in the understanding of the wear mechanisms of UHMWPE bearing surfaces.

Computer Simulation↗

Elastohydrodynamic lubrication analysis of a functionally graded layered bearing surface, with particular reference to 'cushion form bearings' for artificial knee joints.

Elastohydrodynamic lubrication of a functionally graded layered (FGL) bearing surface, whose elastic modulus increases with depth from the bearing surface, was investigated in this study. The finite difference method was employed to solve the Reynolds equation, simultaneously with the elasticity equation of the bearing surface, under circular point contacts. The finite element method was adopted to solve the elasticity equation for the FGL bearing surface. The displacement coefficients thus obtained were used to calculate the elastic deformation of the bearing surface, required for the elastohydrodynamic lubrication analysis. Good agreement of the predicted film thickness and pressure distribution was obtained, between the present method and a previous study for a single layered bearing surface with a uniform elastic modulus. The general numerical methodology was then applied to an FGL bearing surface with both linear and exponential variations in elastic modulus, with particular reference to the 'cushion form bearing' for artificial knee joints. The predicted film thickness and pressure distribution were shown to be quite close to those obtained for a single layer under typical operating conditions representative of artificial knee joints, provided that the elastic modulus of the single layer was chosen to be the average elastic modulus of the graded layer.

Coated Materials, Biocompatible↗

Contact mechanics of metal-on-metal hip implants employing a metallic cup with a UHMWPE backing.

The contact mechanics in metal-on-metal hip implants employing a cobalt chromium acetabular cup with an ultra-high molecular weight polyethylene (UHMWPE) backing were analysed in the present study using the finite element method. A general modelling methodology was developed to examine the effects of the interfacial boundary conditions between the UHMWPE backing and a titanium shell for cementless fixation, the coefficient of friction and the loading angle on the predicted contact pressure distribution at the articulating surfaces. It was found that the contact mechanics at the bearing surfaces were significantly affected by the UHMWPE backing. Consequently, a relatively constant pressure distribution was predicted within the contact conjunction, and the maximum contact pressure occurred towards the edge of the contact. On the other hand, the interfacial boundary condition between the UHMWPE backing and the titanium shell, the coefficient of friction and the loading angle were found to have a negligible effect on the contact mechanics at the bearing surfaces. Overall, the magnitude of the contact pressure was significantly reduced, compared with a similar cup without the UHMWPE backing. The importance of the UHMWPE backing on the tribological performance of metal-on-metal hip implants is discussed.

Chromium Alloys↗

Analysis of mixed lubrication mechanism in metal-on-metal hip joint replacements.

A simple mixed lubrication model has been developed to predict the asperity contact and wear for the metal-on-metal bearing couple for total hip joint replacements. It has been shown that the femoral head radius has a large effect on the predicted asperity contact and wear depending on the lubrication regime. An increase in the femoral head radius can lead to an increase in wear under a predominantly boundary lubrication regime, but this trend can be reversed under a mixed lubrication regime towards fluid film lubrication. These observations are consistent with the recent experimental findings from hip simulator studies by Smith and co-workers.

Arthroplasty, Replacement, Hip↗

Analysis of elastohydrodynamic lubrication in a novel metal-on-metal hip joint replacement.

Elastohydrodynamic lubrication (EHL) analysis was carried out in this study for a novel metal-on-metal hip prosthesis, which consists of a cobalt-chrome alloy femoral head articulating against a cobalt-chrome alloy acetabular insert connected to a titanium fixation shell through a taper. Finite element models were developed to investigate the effect of the pelvic bone and the load on the predicted contact pressure distribution between the two bearing surfaces under dry conditions. The finite element method was used to develop elasticity models for both the femoral and the acetabular components; it was found that the elastic deformation of the acetabular insert was mainly dependent on the load, rather than the detailed pressure distribution. A modified solution methodology was accordingly developed to couple the elasticity models for both the femoral and the acetabular surfaces with the Reynolds equation and to solve these numerically by the finite difference method. It was found that a load increase from 500 to 2500 N had a negligible effect on the predicted maximum contact pressure and the minimum film thickness, due to the relatively flexible and accommodating structure of the acetabular insert. Furthermore, the predicted minimum film thickness was shown to be significantly greater than the simple estimation based on the assumption of semi-infinite solids (mono-block design) using the Hamrock and Dowson formula. The effects of the viscosity of the lubricant and the radial clearance between the femoral and the acetabular components on the predicted lubricating film thickness were investigated under both in vitro simulator testing and in vivo walking conditions.

Algorithms↗