Clinically Relevant Artificial Lubricants for Implant Wear Testing

点击翻译按钮获取中文摘要

Total joint arthroplasty (TJA) is a well established surgical intervention used to provide pain relief and improve the quality of life for patients suffering from arthritis. With increasing life expectancy and a growing trend that points to younger and more active patients undergoing TJA, it is even more imperative to maximize the longevity of these medical devices. TJAs can fail due to wear-particle induced bone resorption that can cause expensive and time-intensive revision surgery; a surgery that is also associated with a higher risk of patient morbidity. Wear evaluation of total joint replacements prior to large scale implantation has become a standardized procedure to identify bearing material wear characteristics, and to estimate their possible in vivo wear performance; however, current standardized test conditions have shown that the lubricants` biochemical and microbiological characteristics do not match the in vivo conditions. The main objective of this present proposal is to develop and validate a more clinically relevant lubricant for implant (hip and knee) wear testing that is supported by both clinical findings and by in vitro wear tests. In order to achieve this objective, a multi-disciplinary approach is required. This approach involves a combination of mechanical engineering, orthopaedic, biochemical, and microbiological research to develop a more clinically relevant lubricant that permits the sterile evaluation of implants in vitro. The proposed studies include the analysis of synovial fluid from patients, followed by in vitro simulator wear testing, wear particle assessment, wear surface analysis, and computational modeling of the wear process, all of which are an integral part of interdisciplinary research and medical device product development. Using the developed knowledge of implant lubrication, the proposed research will extend in the long term to the modeling of the lubrication phenomena that occur in both joint simulator testing and in vivo. These endeavors will generate scientific evidence to encourage national and international regulatory bodies to gradually integrate the new scientific knowledge into standardized test procedures, which may facilitate the development of more durable implants.