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Wear in totaI

joint
repIacements
Orthopaedic Devices
WEAR
Loss of material (usually due to contact)
Abrasion, adhesion, fretting
Delamination, pitting (fatigue)
Depends on friction, lubrication, contact
area,surface finish and level of loads
(stresses)
Relevance
Over half a million hips
and knees are
replaced every year
6% need revision
within 10 years (AAOS)
UHMWPE articulates
against Co-Cr
Polymer component is
the weak link due to
fatigue,fracture, wear
www.medicalmultimediagroup.com www.exac.com
Mode 1: Articulation between intended surfaces--
femoral head and acetabular cup
Mode 2: Articulation of primary bearing surface and a
material that was never intended to be a bearing
surface--femoral head and metal backing ( an
UHMWPE acetabular lining that has worn though to its
metal backing)
Mode 3: Articulation between intended surfaces but in
the presence of 3rd body particles--PMMA, bone,
metal debris
Mode 4: Articulation between 2 non bearing secondary
surfaces. Backside wear is an example--back of
poyethylene insert on its metal backing
Four Modes of Wear in TJR
Mechanisms of Wear
Five major mechanisms of wear:
-adhesive
-abrasive
-3rd body
-fatigue
-corrosion
Adhesive wear
Adhesive wear occurs when the atomic forces
occurring between two materials in contact is
stronger than the inherent property in either
material--bonding and fracture of asperities--
creates wear debris. Usually occurs when
UHMWPE adheres to the counter bearing
surface--surface roughness in important. Linked
to plastic flow in UHMWPE. Associated with
plastic strain "plasticity induced damage layer
due to multiaxial loading conditions in the hip--
generates submicron debris.
Abrasive, 3rd Body, Corrosion Wear
Abrasive wear occurs between surfaces with different
levels of hardness. Asperities on the harder surface
plough through the softer material. Thus the surface
roughness of Co-Cr or Alumina is important when it
articulates against the softer UHMWPE.
Third Body wear is form of abrasive wear. Hard
particles become embedded in the soft surface--bone
cement in UHMWPE. This can damage both surfaces
leading to polymer and metal debris.
Corrosion wear is an indirect wear mechanism--form
of third body wear.
RMS Roughness of Different
Components
Scholes, SC; Unsworth, A; Goldsmith, AAJ. Phys Med Biol, 2000
*note: "metal is CoCrMo
Wear mechanisms
Generation of wear debris
Major types of wear in
totaI hip repIacement:
adhesive and abrasive
Both from unlubricated
interfacial adhesion
that removes particles
from softer surface
Abrasive wear can
also involve 3
rd
body
wear
incomplete layer of
lubricant causes direct
contact between
sliding surfaces
boundary lubrication
Wear volume:
ncrease in lubrication
leads to a decrease in k
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Wear-Mediated Osteolysis
osteoblast
osteoclast/
polymorphonuclear
giant cell
http://academic.brooklyn.cuny.edu/biology/bio4fv/page/aviruses/cellular-immune.html
Archibeck, MJ; Jacobs, JJ; Roebuck, KA; Glant, TT. ournal of Bone & oint Surg, 2000
wear particles
osteolysis
opsonization
phagocytosis
disrupted balance between
osteoclasts/PMNs and
osteoblasts:
osteoclasts , osteoblasts
Fatigue Wear
atigue wear occurs when the fatigue limit of a
material is exceeded or when subsurface shear
stresses and contact stresses lead to
subsurface crack growth. This leads to
delamination and pitting (larger debris than
generated through adhesive/abrasive
mechanisms). Observed in tibial components
due to large cyclic contact stress and in hips at
rim (rim cracking). Can also be associated with
oxidation embrittlement.
Wear Mechanisms in TKR
Knees are less conforming than hips. Higher contact
stresses lead to fatigue wear mechanisms--
delamination and pitting.
Wear Damage Analysis
n each area, we look for the presence
of eight modes of damage:
pitting
2 surface deformation or coId fIow
3 scratching
4 burnishing
5 embedded PMMA debris
6 abrasion
7 deIamination
8 fracture
The severity of each damage mode in
each area is scored on a scale of 0 (not
present) to 3 (present on >50% of
area). Scores for each damage
mode in each area are combined to
give a total damage score for the
component
Assessment of Retrievals
W Retrievals help us assess the role of
materials, conformity, design,
sterilization/aging on wear mechanisms
Design affects stress states, failure
mechanisms, life of device
Design philosophy is not always obvious
Better life prediction models needed to
capture in vivo behavior
Conformity
Conformity affects contact stresses
Differences arise in design of device
nitial wear mechanisms affected by both
stresses and materials selection
Counterface surface condition affects wear
behavior
Conformity in Total Joint
Replacements
Determined by the radial clearance between articulating
components
The contact area influences the magnitude of stresses
experienced by both components of total joint replacements
The hip joint is more conforming than the knee joint
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Relevant reading
What are the wear mechanisms and what
controls them? AAOS, 2001. (pdf, class
website).

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