In vitro lateral versus medial wear of a knee prosthesis
In vitro lateral versus medial wear of a knee prosthesis
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DOI：
10.1016/s0043-1648(03)00271-0
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发表时间：
2003-08-01
期刊：
影响因子：
5
通讯作者：
Crowninshield, RD
中科院分区：
文献类型：
--
作者：
Laurent, MP;Johnson, TS;Crowninshield, RD
进行膝关节磨损试验，其中分别测量内侧和外侧胫骨部件的磨损，以确定内侧-外侧（M-L）磨损分布并深入了解操作磨损机制。这是通过在位移控制磨损模拟器中对全膝关节、6个内侧和6个外侧低限制型单髁高分子量聚乙烯（UHMWPE）假体部件进行配对和磨损测试来实现的。发现内侧和外侧部件的累积重量磨损率显著不同，分别为6.58 +/- 0.50和2.93 +/- 0.29 mg/百万次循环。这相当于内侧部件磨损增加124 +/- 25%，尽管两个部件上的载荷相似。这种内外侧磨损差异似乎与UHMWPE磨损率对多向剪切效应的公认敏感性有关。因此，开发了一个磨损模型，其中只有横向滑动组件对UHMWPE的磨损有显著影响。该模型与观察到的内外侧磨损差异非常一致。该模型的横向磨损效应占内侧部件磨损增加的63%。考虑到磨损痕迹的长度，这个数字增加到88%，这与观察值124 +/- 25%（标准误差），+/- 65%（95%CI）非常一致。需要进一步完善胫骨-股骨滑动运动路径和横向聚乙烯磨损模型的计算。(C)2003 Elsevier Science B. V.保留所有权利。
A knee wear test was conducted in which the wear of the medial and lateral tibial components was measured separately to determine the medial-lateral (M-L) wear distribution and gain insight into the operating wear mechanisms. This was achieved by pairing and wear testing as a total knee, six medial and six lateral low constraint unicondylar ultrahigh molecular weight polyethylene (UHMWPE) prosthetic components in a displacement-controlled wear simulator. The medial and lateral components were found to have substantially different cumulative gravimetric wear rates, 6.58 +/- 0.50 and 2.93 +/- 0.29 mg per million cycles, respectively. This corresponds to 124 +/- 25% more wear on the medial component, despite similar loading on both components. This differential medial-lateral wear appears to be connected with the well-established sensitivity of the UHMWPE wear rate to multidirectional shear effects. A wear model was thus developed in which only the transverse sliding component contributes significantly to the wear of UHMWPE. The model was shown to be in good agreement with this observed differential medial-lateral wear. This transverse wear effect from the model accounts for 63% of the increased medial component wear. Taking into account the lengths of the wear tracks, this number increased to 88%, which is in good agreement with the observed value of 124 +/- 25% (standard error), +/- 65% (95% CI). Further work is required to refine the calculations of the tibio-femoral sliding motion paths and the transverse polyethylene wear model. (C) 2003 Elsevier Science B.V. All rights reserved.