Many studies have looked at the effect of titanium versus cobalt chrome baseplates on backside wear. However, the surface finish of the materials is usually different [1,2]. There may also be subtle locking mechanism design changes [2]. The purpose of this study was to evaluate the wear performance of polyethylene inserts when mated with titanium baseplates to cobalt chrome baseplates, where both have non-polished topside surfaces and an identical locking mechanism. A total of three trays per material were used. The titanium trays are intended for cementless application and include a porous titanium surface on the underside, while the cobalt chrome trays are intended for cemented applications. All trays were Triathlon design (Stryker Orthopaedics, Mahwah, NJ). Tibial inserts were manufactured from GUR 1020 polyethylene then vacuum/flush packaged and sterilized in nitrogen (30 kGy). Cobalt chrome femoral components were articulated against the tibial inserts. Surface roughness of the baseplates was measured prior to testing using white light interferometry (Zygo, Middlefield, CT). A 6-station knee simulator (MTS, Eden Prairie, MN) was used for testing. A normal walking profile was applied [3]. Testing was conducted for 1 million cycles. A lubricant of Alpha Calf Fraction serum (Hyclone Labs, Logan, UT) diluted to 50% with a pH-balanced 20-mMole solution of deionized water and EDTA was used [4]. The serum solution was replaced and inserts were weighed for wear every 0.5 million cycles. Standard test protocols were used for cleaning, weighing, and assessing the wear loss [5]. Soak control specimens were used to correct for fluid absorption. Statistical analysis was performed using the Student's t-test (p < 0.05).INTRODUCTION
MATERIALS AND METHODS:
Wear and fracture of patellar components has been frequently reported as a failure mode for cemented and press-fit patellar components. Malalignment of the patellar components may cause higher contact stresses, which may lead to excessive wear, delamination, and/or component fracture. A 6 station MTS (Eden Prairie, MN) knee joint wear simulator and Alpha Calf Fraction serum (Hyclone Labs, Logan, UT) diluted to 50% with a pH-balanced 20-mMole solution of deionized water and EDTA was used (protein level = 20 g/l) for testing. Asymmetric, all-polyethylene, patellar components with an overall construct thickness of 11 mm (Duracon®, Stryker Orthopaedics, Mahwah, NJ) were used. Appropriately sized cobalt-chrome femoral components articulated against the patellae. The patellae were cemented (Simplex, Stryker Orthopaedics, Mahwah, NJ) to delrin fixtures, which placed the patella in 10° of lateral tilt (Figure 1). This angle was chosen based off the work of Huang et al, which was one of the larger average tilt angles reported The loading and kinematic profiles used for testing were published previously (maximum axial load: 2450N and maximum patellofemoral angle: 54°. Variations of the loading profile were studied by evaluating the effects of heavier patients, which increased the maximum axial load to 3100N(250lb patient) and 3750N(300lb patient) (Figure 2). Lateral offset was tested to evaluate the effect of malalignment. Increments of 1mm were analyzed starting from the neutral position, eventually reaching a maximum lateral offset of 5mm. A 6-dof load cell was placed beneath the patella fixturing to capture dynamic loads (ATI, Apex, NC). The axial and medial/lateral shear loads where used to calculate the resultant medial/lateral shear force being applied to the patellar pegs.INTRODUCTION
MATERIALS AND METHODS
Many studies have looked at the effects of titanium tibial baseplates compared to cobalt chrome baseplates on backside wear. However, the surface finish of the materials is usually different (polished/unpolished) [1,2]. Backside wear may be a function not only of tray material but also of the locking mechanism. The purpose of this study was to evaluate the wear performance of conventional polyethylene inserts when mated with titanium tibial trays or cobalt chrome tibial trays that both have non-polished topside surfaces. Three titanium (Ti) trays were used along with three cobalt chrome (CoCr) trays. The Ti trays underwent Type II anodization prior to testing. All trays were Triathlon® design (Stryker Orthopaedics, Mahwah, NJ). Tibial inserts were manufactured from GUR 1020 conventional polyethylene then vacuum/flush packaged and sterilized in nitrogen (30 kGy). Appropriate sized CoCr femoral components articulated against the tibial inserts (Triathlon®, Stryker Orthopaedics, Mahwah, NJ). Surface roughness of the tibial trays was taken prior to testing using white light interferometry (Zygo Corp, Middlefield, CT). A 6-station knee simulator (MTS, Eden Prairie, MN) was used for testing. Two phases were conducted. The first phase used a normal walking profile, as dictated by ISO 14243-3 [3]. The second phase used waveforms created specifically for stair climbing kinematics. Testing was conducted at a frequency of 1 Hz for 2 million cycles for each test with a lubricant of Alpha Calf Fraction serum (Hyclone Labs, Logan, UT) diluted to 50% with a pH-balanced 20-mMole solution of deionized water and EDTA (protein level = 20 g/l) [4]. The serum solution was replaced and inserts were weighed for gravimetric wear at least every 0.5 million cycles. Standard test protocols were used for cleaning, weighing and assessing the wear loss of the tibial inserts [5]. Soak control specimens were used to correct for fluid absorption with weight loss data converted to volumetric data (by material density). Statistical analysis was performed using the Student's t-test (p<0.05).INTRODUCTION
MATERIALS AND METHODS
For cementless TKA, highly crosslinked UHWMPE is traditionally used with modular components because of manufacturing and sterilization complexities of monoblock metal-backed components. However, it would be very useful to have a highly crosslinked UHMWPE monoblock metal-backed cementless component to address historical clinical issues. The purpose of this study was to evaluate the wear properties of a unique process for achieving a monoblock metal-backed cementless component featuring highly crosslinked polyethylene to standard highly crosslinked UHWMPE. The knee system used for testing consisted of cobalt chrome femoral components and tibial trays (Triathlon®, Stryker Orthopaedics, Mahwah, NJ). Modular tibial inserts were machined from GUR 1020 polyethylene that was irradiated to 30 kGy and annealed three times (Modular, n=5) (X3, Stryker Orthopaedics, Mahwah, NJ). Monoblock tibias were direct compression molded to a metal substrate and then irradiated to 30 kGy and annealed three times. For the purposes of this test, the polyethylene was removed from the monoblock component and machined into a standard tibial insert (Monoblock, n=5). A 6-station knee simulator was utilized for testing (MTS, Eden Prairie, MN). All motion and loading was computer controlled and waveforms followed ISO 14243-3 [1]. Testing was conducted at a frequency of 1 Hz for 3 million cycles. The lubricant used was Alpha Calf Fraction serum (Hyclone Labs, Logan, UT) diluted to 50% with a pH-balanced 20-mMole solution of deionized water and EDTA [2]. The serum solution was replaced and inserts were weighed for gravimetric wear at least every 0.5 million cycles. Standard test protocols were used for cleaning, weighing and assessing the wear loss of the tibial inserts [3]. Soak control specimens were used to correct for fluid absorption with weight loss data converted to volumetric data (by material density). Statistical analysis was performed using the Student's t-test with significance determined at the 95% confidence level (p < 0.05).INTRODUCTION
MATERIALS AND METHODS
Ultra-high molecular weight polyethylene (UHMWPE) has been successfully used as a bearing material in total joint arthroplasty. However, longevity of these implants has been compromised by wear and fatigue damage of the polyethylene. The addition of vitamin E to the polyethylene is a process recently introduced in the market to stabilize free radicals produced during radiation crosslinking. The objective of the present study is to investigate the effect of the addition of vitamin E on the wear characteristics of UHMWPE. Sequentially cross-linked and annealed UHMWPE material (X3™, Stryker Orthopaedics, Mahwah, NJ) was used as a control. Trident™ acetabular cups (Stryker Orthopaedics, Mahwah, NJ) with inner diameters of 36 mm and 44 mm and a wall thickness of 3.8 mm were tested on a 12 station MTS hip joint simulator. The simulator used a physiologic loading pattern with a maximum load of 2450N. The test was conducted under standard clean conditions with alpha calf fraction serum diluted to a protein concentration of 20 g/l for a total of three million cycles. All cups ran against CoCr femoral heads, and gravimetric measurements were taken every half-million cycles. Results show that sequentially crosslinked components, size 3 6mm, had an average volume loss of 9.4 ± 2.5 mm3, while vitamin E components of the same size had an average of 16.5 ± 3.1 mm3. This represents a 75% increase for vitamin E components that is statistically significant (p = 0.039). Size 44 mm sequentially crosslinked components had an average volume loss of 6.8 ± 3.7 mm3, while vitamin E components had an average of 19.7 ± 3.2 mm3. This denotes a statistically significant increase of 192% for material with vitamin E (p = 0.011). Linear regression analysis yielded wear rates of 4.1 ± 0.9 mm3/mc and 6.1 ± 1.3 mm3/mc for size 36 mm sequentially crosslinked and vitamin E components, respectively, which represents a non-significant increase of 49% for vitamin E components. Size 44 mm sequentially crosslinked components had a wear rate of 3.8 ± 1.3mm3/mc, while vitamin E components had a wear rate of 8.1 ± 0.7 mm3/mc. This represents a statistically significant increase of 117% in wear rate for vitamin E components (p = 0.013). The results of this testing indicate that the addition of vitamin E degrades wear performance relative to sequentially crosslinked material. Research shows that the introduction of Vitamin E affects the ability to create crosslinks during irradiation by reacting with some of the free radicals. Oral et al have shown that the crosslink density decreases when Vitamin E is blended into UHMWPE. Their research has also shown that a decrease in crosslink density causes an increase in wear rate. The results of the current testing show that the addition of vitamin E to polyethylene reduces the wear resistance of highly crosslinked polyethylene.
