Inactivation of a subpopulation of human neutrophils by exposure to ultrahigh-molecular-weight polyethylene wear debris

Polymorphonuclear neutrophils, a first line of defence against invading microbial pathogens, may be attracted by inflammatory mediators triggered by ultrahigh-molecular-weight polyethylene (UHMWPE) wear particles released from orthopaedic prostheses. Phagocytosis of UHMWPE particles by neutrophils may indirectly compromise their phagocytic-bactericidal mechanisms, thus enhancing host susceptibility to microbial infections. In an in vitro assay, pre-exposure of purified human neutrophils to UHMWPE micrometre- and submicrometre-sized wear particles interfered with subsequent Staphylococcos aureus uptake in a heterogeneous way, as assessed by a dual label fluorescence microscopic assay that discriminated intracellular rhodamine-labelled UHMWPE particles from fluorescein isothiocyanate-labelled S. aureus. Indeed, a higher percentage (44%) of neutrophils having engulfed UHMWPE particles lost the ability to phagocytize S. aureus, compared with UHMWPE-free neutrophils (<3%). Pre-exposure of neutrophils to UHMWPE wear particles did not impair but rather stimulated their oxidative burst response in a chemoluminescence assay. The presence of UHMWPE wear particles did not lead to significant overall consumption of complement-mediated opsonic factors nor decreased surface membrane display of neutrophil complement receptors. In conclusion, engulfment of UHMWPE wear particles led to inactivation of S. aureus uptake in nearly half of the neutrophil population, which may potentially impair host clearance mechanisms against pyogenic infections.     

Preparation of UHMWPE particles and establishment of inverted macrophage cell model to investigate wear particles induced bioactivites

Total joint replacement surgery has been widely applied to patients with severe osteoarthritis. Aseptic loosening induced by wear particles generated during joint movement is the major reason causing the failure of joint implants. Interaction of ultra-high molecular weight polyethylene (UHMWPE) wear particles with macrophages stimulates the release of inflammatory cytokines and leads to bone resorption and osteolysis. Effect of UHMWPE particle size and shape on the bioactivities remains unclear due to the lack of particles with controlled morphology as well as adequate in-vitro cell culture models for further investigations. We have developed a micro-cutting procedure to generate UHMWPE particles with desired sizes and shapes by rubbing UHMWPE with microfabricated surfaces. A narrow distribution and sterility of the generated particles was achieved. An inverted cell culturing apparatus and procedures were created and the contact between particles and macrophage cells was observed. No significant difference of the cell proliferations under normal and inverted positions further demonstrates the feasibility of the system. This newly developed platform can assist in the further understanding of the mechanism and therapy strategies of osteolysis induced by polyethylene particles.     

Chondrocyte acting as phagocyte to internalize polyethylene wear particles and leads to the elevations of osteoarthritis associated NO and PGE2

It remains a mystery about the role of chondrocyte or cartilage on the co-existence of ultra-high molecular weight polyethylene (UHMWPE) wear particles from partial joint arthroplasty. An inverted co-culture system was performed to investigate the interactions between chondrocytes and UHMWPE wear particles. It was first time observed that chondrocytes can engulf UHMWPE particles and release osteoarthritis associated pro-inflammatory factors. TEM observation and flow cytometric analysis demonstrated the phagocytosis of particles by chondrocytes. It was found that polyethylene particles may reduce the viability of chondrocytes, and enhance the secretion of nitric oxide (NO) and PGE₂. In conclusion, all these phenomena may contribute to further cartilage degeneration after partial joint arthroplasty surgery. It is first identified in this study that the chondrocyte acts as phagocyte to internalize wear particles and leads to the elevations of precursor mediators of osteoarthritis.     

人工关节假体无菌性松动动物模型的快速建立

目的:人工关节置换手术发展至今,取得了非常大的成功,已在临床解决了许多终末期的关节疾患。研究表明,假体无菌性松动的患者,其假体周围处于高骨更新状态。因此骨-假体界面的早期整合对于阻止磨屑颗粒和细胞因子的迁移至关重要,而限制人工关节假体使用寿命的一个主要原因是磨屑颗粒诱导的假体无菌性松动。在本研究中,我们旨在尝试使用107个UHMWPE颗粒快速建立人工关节假体无菌性松动的兔动物模型,以便为进一步探讨假体无菌性松动的机制及防治奠定实验基础。方法:我们用雌性新西兰大白兔建立动物模型,随机均分为实验组和对照组,在两组动物的左侧胫骨髓腔内植入羟基磷灰石(hydroxyapatite,HA)涂层假体。在实验组中,分别于假体表面和膝关节腔内植入0.5×10~7超高分子量聚乙烯(Ultra-high molecular weight polyethylene,UHMWPE)颗粒。结果:同对照组相比,实验组动物的关节内压力更高、骨组织形态学参数更差、假体生物力学固定强度更低,同时,促炎细胞因子和骨更新标志均显著高于对照组。结论:我们使用很少的UHMWPE颗粒成功快速地建立了人工关节假体无菌性松动的兔动物模型,从而为今后人工关节假体无菌性松动的进一步研究奠定了实验基础。     

Study on Tribological Properties of Irradiated Crosslinking UHMWPE Nano-Composite

Ultra High Molecular Weight Polyethylene(UHMWPE)has been widely used as a bearing material for artificial joint replacementover forty years.It is usually crosslinked by gamma rays irradiation before its implantation into human body.In thisstudy,UHMWPE and UHMWPE/nano-hydroxyapatite(n-HA)composite were prepared by vacuum hot-pressing method.Theprepared materials were irradiated by gamma rays in vacuum and molten heat treated in vacuum just after irradiation.The effectof filling n-HA with gamma irradiation on tribological properties of UHMWPE was investigated by using friction and wearexperimental machine(model MM-200)under deionized water lubrication.Micro-morphology of worn surface was observedby metallographic microscope.Contact angle and hardness of the materials were also measured.The results show that contactangle and hardness are changed by filling n-HA and gamma irradiation.Friction coefficient and wear rate under deionized waterlubrication are reduced by filling n-HA.While friction coefficient is increased and wear rate is reduced significantly by gammairradiation.The worn surface of unfilled material is mainly characterized as adhesive wear and abrasive wear,and that of n-HAfilled material is mainly characterized as abrasive wear.After gamma irradiation,the degrees of adhesive and abrasive wear forunfilled material and abrasive wear of n-HA filled material are significantly reduced.Unfilled and filled materials after irradiationare mainly shown as slight fatigue wear.The results indicate that UHMWPE and UHMWPE/n-HA irradiated at the doseof 150 kGy can be used as bearing materials in artificial joints for its excellent wear resistance compared to original UHMWPE.     

Defect-related luminescent bur-like hydroxyapatite microspheres induced apoptosis of MC3T3-E1 cells by lysosomal and mitochondrial pathways

When orthopedic joints coated by hydroxyapatite(HA) were implanted in the human body, they release wear debris into the surrounding tissues. The generation and accumulation of wear particles will induce aseptic loosening. However, the potential bioeffect and mechanism of HA-coated orthopedic implants on bone cells are poorly understood. In this study, defect-related luminescent bur-like hydroxyapatite(BHA) microspheres with the average diameter of 7–9 μm which are comparable to that of the wear-debris particles from aseptically loosened HA implants or HA debris have been synthesized by hydrothermal synthesis and the MC3 T3-E1 cells were set as a cells model to study the potential bioeffect and mechanism of BHA microspheres. The studies demonstrated that BHA microspheres could be taken into MC3 T3-E1 cells via endocytosis involved in micropinocytosisand clathrin-mediated endocytosis process, and exert cytotoxicity effect. BHA microspheres could induce the cell apoptosis by intracellular production of reactive oxygen species(ROS), which led to not only an increase in the permeability of lysosome and release of cathepsins B, but also mitochondrial dysfunction and DNA damage. Our results provide novel evidence to elucidate their toxicity mechanisms and might be helpful for more reasonable applications of HA-based orthopaedic implants in the future.     

运用偏振光观测聚乙烯磨屑颗粒诱导人工关节假体无菌性松动

目的:探讨运用偏振光显微镜来观测无菌性松动人工关节假体周围的聚乙烯颗粒分布,评估其在研究磨屑颗粒诱导假体无菌性松动机制及防治措施等实验研究中的可行性。方法:我们用雌性新西兰大白兔建立动物模型,在左侧胫骨髓腔内植入羟基磷灰石(hydroxyapatite,HA)涂层假体。并分别于假体表面和膝关节腔内植入0.5×107超高分子量聚乙烯(Ultra-high molecular weight polyethylene,UHMWPE)颗粒。术后行四环素荧光双标记。膝关节滑膜组织苏木精-伊红(hematoxylin-eosin,HE)染色、骨组织改良丽春红染色后分别用普通光镜和偏振光镜观察,未染色的骨组织行荧光显微镜和偏振光镜观察。结果:在聚乙烯颗粒刺激下,膝关节滑膜组织增生明显,骨-假体结合差,假体周围骨小梁稀疏,偏振光显微镜可清晰显示双折光性的聚乙烯颗粒在膝关节分布于滑膜及其深层结缔组织中,在骨-假体间隙间大量充填,阻碍骨-假体整合。结论:运用偏振光显微镜可以清晰而简便地观察滑膜和假体周围的聚乙烯颗粒分布,与传统实验方法相比,更加直观、简便和经济。     

Experimental and numerical modeling of variable friction between nanoregions in coventional and crosslinked UHMWPE

Recently, highly crosslinked UHMWPE components have been promoted for their high abrasive wear resistance over conventional UHMWPE (PE) in total joint replacement (TJR) prostheses to minimize osteolysis and consequent implant loosening. This study was aimed at investigating the role of friction gradients induced by localized coefficients of friction at both crystalline and amorphous nanoregions in PE, and crystalline and crosslinked nanoregions in crosslinked UHMWPE (XPE), in submicron wear debris generation. An abrasive wear study performed on both XPE and PE using atomic force microscopy (AFM) illustrated that the onset of plastic deformation for XPE occurred at a normal load that was approximately 3 times higher when compared to PE. Coefficients of friction (mu d) of 0.2, 0.35, and 0.61, experimentally derived using AFM, were used as representative mu d for crystalline, amorphous, and crosslinked nanoregions, respectively, in a numerical Hertzian model. An increase in mu (0.2 +/- 0.02, 0.35 +/- 0.01 and 0.6 +/- 0.04) was observed with a decrease in crystallinity and storage modulus at 22 degrees C. Using the Hertzian contact model, it was observed that variability in friction between nanoregions contributed to higher magnitude stresses for XPE (0.2 to 0.61; maximum sigma eff = 2.8) compared to PE (0.2 to 0.35; maximum sigma eff = 1.1) over a negligible thickness of the interfacial zone (IZ) between nanoregions. The experimentally observed increase in abrasive wear resistance of XPE could be attributed to an increase in the thickness of the interfacial zone between nanoregions with mu changing gradually from crystalline to crosslinked nanoregions, a situation that may not be observed with PE. This would cause a decrease in the friction gradient and resulting stresses thereby agreeing with the observed experimental higher abrasive wear resistance for XPE. However, in both PE and XPE, the presence of stress concentrations over a period of time could lead to irreversible damage of the material eventually generating submicron wear debris. Hence, semicrystalline, inhomogenous UHMWPE with several nanoregions (amorphous and crystalline) would be at a disadvantage for bearing application in terms of abrasive wear resistance compared to UHMWPE with relatively lower number of nanoregions and crosslinked nanoregions.     

Study of Tetrapodal ZnO-PDMS Composites: A Comparison of Fillers Shapes in Stiffness and Hydrophobicity Improvements

ZnO particles of different size and structures were used as fillers to modify the silicone rubber, in order to reveal the effect of the filler shape in the polymer composites. Tetrapodal shaped microparticles, short microfibers/whiskers, and nanosized spherical particles from ZnO have been used as fillers to fabricate the different ZnO-Silicone composites. The detailed microstructures of the fillers as well as synthesized composites using scanning electron microscopy have been presented here. The tensile elastic modulus and water contact angle, which are important parameters for bio-mimetic applications, of fabricated composites with different fillers have been measured and compared. Among all three types of fillers, tetrapodal shaped ZnO microparticles showed the best performance in terms of increase in hydrophobicity of material cross-section as well as the stiffness of the composites. It has been demonstrated that the tetrapodal shaped microparticles gain their advantage due to the special shape, which avoids agglomeration problems as in the case for nanoparticles, and the difficulty of achieving truly random distribution for whisker fillers.     

Effect of filler content and size on transport properties of water vapor in PLA/calcium sulfate composites

Starting from calcium sulfate (gypsum) as fermentation byproduct of lactic acid production process, high-performance composites have been produced by melt-blending polylactide (PLA) and beta-anhydrite II (AII) filler, i.e., calcium sulfate hemihydrate previously dried at 500 degrees C. Characterized by attractive properties due to good filler dispersion throughout the polyester matrix and favorable interactions between components, these composites are interesting for potential use as biodegradable rigid packaging. The effect of filler content and mean particle diameter on the barrier properties such as sorption and diffusion to water vapor has been examined and compared to unfilled PLA. Even without additional treatments, the presence of the filler introduced constraints on molecular mobility in the permeable phase of amorphous PLA and the amount of solvent absorbed appears lower in the highly filled composites. Surprisingly, for PLA-30% AII compositions, by addition of filler characterized by high mean particle diameter (e.g., 43 microm) the thermodynamic diffusion parameter, D(0), decreased up to 2 orders of magnitude. The dimension of filler particles and their percentage in the continuous polymeric phase seem to be the most important parameters that determine the barrier properties of the PLA-AII composites to water vapor.     

RandomPOD--a new method and device for advanced wear simulation of orthopaedic biomaterials

A 16-station wear simulator of the pin-on-disc type, called RandomPOD, was designed, built, and validated. The primary area of application of the RandomPOD is wear studies of orthopaedic biomaterials. The type of relative motion between the bearing surfaces, generally illustrated as shapes of slide tracks, has been found to have a strong effect on the type and amount of wear produced. The computer-controlled RandomPOD can be programmed to produce virtually any slide track shape and load profile. In the present study, the focus is on the biomechanically realistic random variation in the track shape and load. In the reference test, the established combination of circular translation and static load was used. In addition, the combinations of random motion/static load, and circular translation/random load were included. The pins were conventional ultra-high molecular weight polyethylene (UHMWPE), the discs were polished CoCr, and the lubricant was diluted calf serum. The UHMWPE wear factor resulting from random motion was significantly higher than that resulting from circular translation. This was probably caused by the fact that in the random motion the direction of sliding changed more than in circular translation with the same sliding distance. The type of load, random vs. static, was unimportant with respect to the wear factor produced. The principal advantage of using the present random track is that possible unrealistic wear phenomena related to the use of fixed track shapes can be avoided.     

Microstructure analysis and wear behavior of titanium cermet femoral head with hard TiC layer

Titanium cermet was successfully synthesized and formed a thin gradient titanium carbide coating on the surface of Ti6Al4V alloy by using a novel sequential carburization under high temperature, while the titanium cermet femoral head was produced. The titanium cermet phase and surface topography were characterized with X-ray diffraction (XRD) and backscattered electron imaging (BSE). And then the wear behavior of titanium cermet femoral head was investigated by using CUMT II artificial joint hip simulator. The surface characterization indicates that carbon effectively diffused into the titanium alloys and formed a hard TiC layer on the Ti6Al4V alloys surface with a micro-porous structure. The artificial hip joint experimental results show that titanium cermet femoral head could not only improve the wear resistance of artificial femoral head, but also decrease the wear of UHMWPE joint cup. In addition, the carburized titanium alloy femoral head could effectively control the UHMWPE debris distribution, and increase the size of UHMWPE debris. All of the results suggest that titanium cermet is a prospective femoral head material in artificial joint.     

Postoperative Changes in In Vivo Measured Friction in Total Hip Joint Prosthesis during Walking

Loosening of the artificial cup and inlay is the most common reasons for total hip replacement failures. Polyethylene wear and aseptic loosening are frequent reasons. Furthermore, over the past few decades, the population of patients receiving total hip replacements has become younger and more active. Hence, a higher level of activity may include an increased risk of implant loosening as a result of friction-induced wear. In this study, an instrumented hip implant was used to measure the contact forces and friction moments in vivo during walking. Subsequently, the three-dimensional coefficient of friction in vivo was calculated over the whole gait cycle. Measurements were collected from ten subjects at several time points between three and twelve months postoperative. No significant change in the average resultant contact force was observed between three and twelve months postoperative. In contrast, a significant decrease of up to 47% was observed in the friction moment. The coefficient of friction also decreased over postoperative time on average. These changes may be caused by ‘running-in’ effects of the gliding components or by the improved lubricating properties of the synovia. Because the walking velocity and contact forces were found to be nearly constant during the observed period, the decrease in friction moment suggests an increase in fluid viscosity. The peak values of the contact force individually varied by 32%-44%. The friction moment individually differed much more, by 110%-129% at three and up to 451% at twelve months postoperative. The maximum coefficient of friction showed the highest individual variability, about 100% at three and up to 914% at twelve months after surgery. These individual variations in the friction parameters were most likely due to different ‘running-in’ effects that were influenced by the individual activity levels and synovia properties.     

生物磁谱分析技术在OA患者关节液磨屑颗粒评估中的初步应用

目的:随着人群的老龄化,骨关节炎(osteoarthritis,OA)已成为老年人最常见的疾病之一,严重影响老年人生活质量。而OA传统的诊断方法敏感性差,往往在确诊时,疾病已经发展到了晚期。本研究拟运用生物磁谱分析技术(bio-ferrography)来初步分析研究OA患者关节液中磨屑颗粒的参数,进而为OA的早期诊断提供依据。方法:选取符合纳入标准的2017年9月至2017年12月我科住院收治的OA患者。采集患者关节液后,运用bio-ferrography技术分离、收集关节液中的软骨磨屑颗粒和骨性磨屑颗粒,进一步通过扫描电镜(scanning electron microscope,SEM)观测磨屑颗粒的外形、数量和大小等参数。结果:随着患者OA等级的进展,软骨颗粒和骨性颗粒的数量均在增加,磨屑颗粒外形变得越来越锐利和不规则。在Kellgren-Lawrence(K-L)1级OA患者的关节液中,无骨性颗粒的存在,在K-L 1～3级OA患者的关节液中,软骨颗粒数量显著多于骨性颗粒。结论:我们初步探讨了通过bio-ferrography技术观测OA患者关节液中的磨屑颗粒,并评估了不同K-L分级OA患者关节液中磨屑颗粒的统计学特点,为今后建立以bio-ferrography技术为基础的OA早期诊断标准奠定了基础。     

Prediction of lubricating film thickness in UHMWPE hip joint replacements

An elastohydrodynamic lubrication model developed for a ball-in-socket configuration in a previous studies by the present authors (Jalali-Vahid et al., Thinning films and tribological interfaces, 26th Leeds-Lyon Symposium on Tribology, 2000, pp. 329-339) was applied to analyse the lubrication problem of a typical artificial hip joint replacement, consisting of an ultra-high molecular weight polyethylene (UHMWPE) acetabular cup against a metallic or ceramic femoral head. The cup was assumed to be stationary whilst the ball was assumed to rotate at a steady angular velocity and under a constant load. A wide range of main design parameters were considered. It has been found that the predicted lubricating film thickness increases with a decrease in the radial clearance, an increase in the femoral head radius, an increase in UHMWPE thickness and a decrease in UHMWPE modulus. However, the predicted lubricating film thicknesses are not found to be sufficiently large in relation to the surface roughness of the cup and head to indicate separation of the two articulating surfaces. It should also be noted that if the design features are unable to secure full fluid film lubrication, it may be preferable to select them for minimum wear rather than maximum film thickness. For example, an increase in head radius will enhance the film thickness, but it will also increase the sliding distance and hence wear in mixed or boundary lubrication conditions. Furthermore, it is pointed out that an increase in the predicted lubricant film thickness is usually associated with an increase in the contact area, and this may cause lubricant starvation and stress concentration at the edge of the cup, and adversely affect the tribological performance of the implant. The effect of running-in process on the lubrication in UHMWPE hip joint replacements is also discussed.     

Wear Testing of Moderate Activities of Daily Living Using In Vivo Measured Knee Joint Loading

Resumption of daily living activities is a basic expectation for patients provided with total knee replacements. However, there is a lack of knowledge regarding the impact of different activities on the wear performance. In this study the wear performance under application of different daily activities has been analyzed. In vivo load data for walking, walking downstairs/upstairs, sitting down/standing up, and cycling (50 W & 120 W) has been standardized for wear testing. Wear testing of each activity was carried out on a knee wear simulator. Additionally, ISO walking was tested for reasons of comparison. Wear was assessed gravimetrically and wear particles were analyzed. In vivo walking produced the highest overall wear rates, which were determined to be three times higher than ISO walking. Moderate wear rates were determined for walking upstairs and downstairs. Low wear rates were determined for standing up/sitting down and cycling at power levels of 50 W and 120 W. The largest wear particles were observed for cycling. Walking based on in vivo data has been shown to be the most wear-relevant activity. Highly demanding activities (stair climbing) produced considerably less wear. Taking into account the expected number of loads, low-impact activities like cycling may have a greater impact on articular wear than highly demanding activities.     

The influence of design, materials and kinematics on the in vitro wear of total knee replacements

Debris-induced osteolysis due to surface wear of ultra high molecular weight polyethylene (UHMWPE) bearings is a potential long-term failure mechanism of total knee replacements (TKR). This study investigated the effect of prosthesis design, kinematics and bearing material on the wear of UHMWPE bearings using a physiological knee simulator. The use of a curved fixed bearing design with stabilised polyethylene bearings reduced wear in comparison to more flat-on-flat components which were sterilised by gamma irradiation in air. Medium levels of crosslinking further improved the wear resistance of fixed bearing TKR due to resistance to strain softening when subjected to multidirectional motion at the femoral-insert articulating interface. Backside motion was shown to be a contributing factor to the overall rate of UHMWPE wear in fixed bearing components. Wear of fixed bearing prostheses was reduced significantly when anterior-posterior displacement and internal-external rotation kinematics were reduced due to decreased cross shear on the articulating surface and a reduction in AP displacement. Rotating platform mobile bearing prostheses exhibited reduced wear rates in comparison to fixed bearing components in these simulator studies due to redistribution of knee motion to two articulating interfaces with more linear motions at each interface. This was observed in two rotating platform designs with different UHMWPE bearing materials. In knee simulator studies, wear of TKR bearings was dependent on kinematics at the articulating surfaces and the prosthesis design, as well as the type of material.     

A comparison of the antiresorptive effects of bisphosphonates and statins on polyethylene particle-induced osteolysis]

An ongoing unraveling of the molecular mechanisms in aseptic loosening of hip arthroplasty has opened up novel potential pharmacological interventions. In this study the antiresorptive effects of the bisphosphonate zoledronate and the statin simvastatin on ultra high molecular weighted polyethylene (UHMWPE) particle-induced osteolysis were compared. Two previous studies of our group based on the murine calvarial model of UHWMPE particle-induced osteolysis were pooled to form four study groups. Animals in group I (n=14) underwent sham surgery only. In groups II (n=14), III (n=7) and IV (n=7) UHMWPE particles were implanted on the calvariae. Animals in groups III and IV were additionally treated with zoledronate (single 25 microg/kg s.c. injection) and simvastatin (120 mg/day p.o. for 14 days), respectively. After two weeks, calvaria were processed for undecalcified histomorphometry. Bone resorption was measured using Giemsa staining. Osteoclast numbers were determined using TRAP-staining. UHMWPE particle implantation resulted in a grossly pronounced osteolytic activity with significantly increased values of bone resorption (p < 0.001) and osteoclast numbers (p < 0.001). Additional treatment with zoledronate or simvastatin counteracted the particle-induced effects. A comparison of the two medical treatments revealed no statistically significant differences in bone resorption (p = 0.63) and osteoclast numbers (p = 0.41). A single dose of the bisphosphonate zoledronate decreased UHMWPE particle-induced osteolysis in a murine calvarial model as effectively as a daily treatment with simvastin. Both drug groups may have a preventive and therapeutic role as antiresorptive agents in wear particle-induced bone resorption following total joint replacement.     

Numerical analysis of the effects of material parameters on the lubrication mechanism for knee prosthesis

The tibial component of current knee prostheses made of ultra high molecular weight polyethylene (UHMWPE) has a high degree of wear that causes knee inflammation, prosthesis loosening and subsequent replacement in not more than 15 years. In order to know which UHMWPE material properties have more influence on wear, a steady state lubrication model with non-Newtonian synovial fluid has been studied through numerical solution. The results show that UHMWPE has a very high elastic modulus that makes difficult a well lubricated artificial joint and induces the formation of very thin lubricating films between the moving surfaces with the same magnitude of roughness components. This study shows that the use of deformable porous materials in the tibial component could cause the lubricating film thickness to be higher than the average roughness and the pressure levels to be lower than the one predicted for UHMWPE. These two facts imply friction and wear reduction.     

An elasto-plastic finite element model for polyethylene wear in total hip arthroplasty

A new finite element model (FEM) based on an elasto-plastic behavior of ultra high molecular weight polyethylene (UHMWPE) was used to study the wear behavior of UHMWPE acetabular cup, which has a 32 mm diameter femoral head. The model imposed a plastic yield stress of 8 MPa on the UHMWPE so that any stresses beyond this would automatically be redistributed to its neighbor. The FEM model adopted a unique mesh design based on an open cube concept which eliminated the problems of singularities. Wear prediction combined the influences of contact stress, sliding distance and a surface wear coefficient. The new model predicted significantly higher volumetric wear rate (57 mm(3)/yr) well within the average reported clinical values. The model was also used to study the effect of friction and clearance between the acetabular cup and the femoral head. Increase in friction increased the volumetric wear rate but did not appear to affect the linear wear rate, which remained at 0.12 +/- 0.02 mm/yr. The predicted wear was sensitive to clearance. It was found that when the clearance was close to 0 and >0.5mm, severe wear occurred. The best clearance range was between 0.1 and 0.15 mm where the average linear wear rate was 0.1mm/yr and the volumetric wear was 55 mm(3)/yr. The present work indicates the importance of avoiding too tight or too loose a diametrical clearance.