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Copyright 2001 American Academy of Orthopaedic Surgeons

What is the role of wear testing


and joint simulator studies
in discriminating among
materials and designs?
aterial selection and component design are important factors in the per!
formance and dura"ility of total joint replacements# $oth la"oratory "ench
tests and joint simulators ha%e "een used to e%aluate the influence of mate!
rials and designs on wear# &he role of wear testing and joint simulation stud!
ies is often unclear' howe%er' in terms of discriminating the effect of materials
and design on performance#
Controlled "ench wear testing should "e used to de%elop an understand!
ing of wear mechanisms and the influence of en%ironmental' design' and
material parameters on wear "eha%ior# (eplicating the specific conditions
occurring in a hip or )nee joint' simulator testing can then "e used to test
specific design and material com"inations# *sed properly' "ench wear test!
ing can also ser%e as a screening tool to identify grossly unsuita"le materials#
Wear is not an intrinsic property of the material "ut rather a function of
the system# &he elements of a wear system include the contact surfaces'
lu"ricant' load' articulating surface speeds' motions' surface roughnesses'
and temperature# &he general conditions e+isting at the contact interface
may not control wear as much as the specific load conditions e+isting at the
asperities on the contact surfaces# *nfortunately' conditions at asperities are
difficult to measure#
Wear is also a function of history# An isolated e%ent at the "eginning of a
wear test can significantly change all su"se,uent e%ents# -f a third!"ody parti!
cle is caught "etween contact surfaces at the "eginning of a test' for e+ample'
and produces a scratch on the metallic surface' the cumulati%e polyethylene
wear at the end of the test may "e 2 to . times what would "e o"ser%ed in
the a"sence of the third!"ody particle#1'2
A wear test is a mechanical test with mo%ing parts# Accordingly' factors
such as alignment and %i"ration can influence the resulting wear measure!
ment much more than other parameters# &he current practice of wear testing
multiple specimens in each e+perimental group does not necessarily resol%e
this issue# Only when all these factors are under reasona"le control can the
difference attri"uta"le to materials "e measured accurately for a gi%en
design# A different degree of wear measured "etween two materials in an in
%itro wear test does not necessarily mean the materials will perform to the
same degree of difference in %i%o# When the critical wear mechanisms are
sufficiently simulated in %itro' then the wear test results can "e claimed clin!
ically rele%ant# &herefore' understanding of the wear mechanisms and the
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-mplant Wear in &otal 1oint (eplacement
2igure 1 A schematic diagram of the chain orientation of ultra!high molecular weight
polyethylene#
associated characteristics 3surface features' wear de"ris si4e and shape5 are
)ey to successful discrimination of materials and designs# Wear mecha!
nisms' in turn' depend on the relati%e material properties of the wear sur!
faces' the contact geometry' speeds' loads' surface roughness' and lu"ricant#.
2or ultra!high molecular weight polyethylene materials' direction of
motion and the fre,uency of motion directional changes also affect wear'/'6
although the reason is not fully understood#7 &his type of polymer is a %is!
coelastic material with molecular weight that ranges from /#6 million to 7
million# -t is composed of folded chains in a crystalline arrangement and
loose amorphous chains with particle domains fused together "y melting
32ig# 15# Cross!lin)ing of chains occurs only in the amorphous regions where
polymer chains are free to "ond with one another# A folded chain has a spe!
cific orientation# Collecti%ely' the chains tend to align and orient themsel%es
in a common direction when the surface is su"jected to a directional force
such as unidirectional ru""ing# Orientation of the surface crystalline domain
chains occurs easily when the surface is cut' polished' or ru""ed#
Soft +!ray a"sorption spectroscopy0'8 can measure the molecular orienta!
tion at polyethylene surfaces su"jected to different motions of wear from a
wear test and a joint simulator test# Similar results ha%e also "een o"ser%ed
on retrie%ed implants# 2igure 2 shows the partial electron yield of a sample
su"jected to soft +!ray "eams under two different sample orientations 3elec!
tric field parallel to and perpendicular to the wear direction5# &he spectrum
difference measures the degree of polymer chain alignment at the ru""ed
surface# 2igure . portrays the difference spectra 3su"tracting the spectrum
perpendicular to the electric field from the parallel spectrum5' in which a
larger difference indicates a higher degree of chain alignment#9
&a"le 1 summari4es the molecular orientation results of %arious cross!
lin)ed samples from a )nee simulator test# Some degree of molecular orien!
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aterial and :esign Considerations
2igure 2 Soft +!ray a"sorption spectra showing the molecular orientation of surface layer
after 2000 unidirectional sliding cycles# ; < electric field
2igure . Soft +!ray a"sorption spectra showing the effect of annealing on two different
polyethylene samples# ; < electric field
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-mplant Wear in &otal 1oint (eplacement
&a"le 1 olecular orientation of polyethylene "efore and after wear for differ!
ent degrees of cross!lin)ing
tation is o"ser%ed for all these cases "ut the rate of orientation %aries for dif!
ferent degrees of cross!lin)ing# &his can "e e+plained "y the different
degrees of freedom of mo%ement of the folded polymer chains as a function
of the degrees of constraint imposed "y cross!lin)ing the chains# 2or the
most highly cross!lin)ed materials' more test time is necessary to "rea) the
cross lin)s and orient the folded chains# &he chain "rea)ing mechanism is
pro"a"ly a mechanical fatigue process at the molecular le%el# &he ease with
which the surface molecules can "e oriented or aligned has se%eral signifi!
cant implications for the o"ser%ed wear phenomena# One hypothesis is that
"y su"jecting the material to unidirectional sliding' the surface molecules
align parallel to the wear direction forming a ,uasi!glassy material# Wear
therefore occurs "y tensile crac)ing and "rittle fracture of the hardened sur!
face layer' producing a relati%ely low amount of wear# When the surface is
su"jected to reciprocating motions' the alignment is not as good "ut still
occurs along the a+is of the motion# ore loosely "ound chains are worn
away' generating more wear# When the surface motion is multia+ial' the sur!
face molecules are in a constant state of flu+ and all fracture modes 3tensile'
shear' and twist5 come into play# &he result is a much higher amount of wear
than in the other cases#10
According to this hypothesis' the "asic wear mechanism for polyethylene
can "e assumed to "e molecular or nanometer in scale' with loose polymer
chains stic)ing out of the surface that are pluc)ed away as the metallic sur!
face slides "y# Additional wear mechanisms from a"rasion 3third!"ody
effect5' contact pressure!induced deformation' and elastic!plastic flow from
160
aterial and :esign Considerations
glo"al contact stresses are seen as well# 2or %iscoelastic and plastic materi!
als' the formation of surface wa%elets in the direction of motion has "een
well documented'11 a possi"le e+planation for the isolated islands o"ser%ed
on the surfaces of retrie%ed implants#12 &he fi"ril wear particles reco%ered
from periprosthetic tissues and from lu"ricating fluids in joint simulators
might also "e e+plained "y the elastic!plastic deformation and the rolling of
thin molecular sheets detached from the su"strate "y fatigue crac)ing#
1oint simulator tests ha%e "een de%eloped to simulate the "iomechanics
of human joints in a controlled condition# (esults from simulator testing can
pro%ide confirmation of the material=s performance for a gi%en geometric
design under a %ariety of operating conditions# $oth controlled wear tests
and joint simulator tests ha%e "een used to esta"lish the conditions necessary
to generate the types of wear damage occurring in hip and )nee joints#1.!18
2or e+ample' multidirectional joint motions are necessary to generate wear
rates and wear particle morphologies that are similar to in %i%o e+perience'
e%en though the multidirectional motions com"ined with the applied loads
imparted "y hip joint simulators do not themsel%es duplicate typical joint
motions that patients might impart across their joints#
&o simulate a )nee joint e+perimentally re,uires more comple+ motions
than simulating a hip joint simply "ecause of the increased degrees of free!
dom# >nee joint simulators ha%e only "een commercially a%aila"le since
1990# &here are two "asic designs of )nee joint simulators' differing pri!
marily in their input signals# -n one type' the operator predefines the applied
loading and the motions 3fle+ion!e+tension' anteroposterior translation' and
internal!e+ternal rotation of the femoral component on the ti"ial compo!
nent5# Surface geometry and friction do not determine the positions of the
femoral component during motion as the simulator dri%es the components
through the predetermined motions# ?alid results rely on a priori )nowledge
of the )inematics# &he correlation of results from this type of simulator with
those o"ser%ed on retrie%ed implants has not "een esta"lished#19!21
-n the second type of )nee simulator design' the inputs are forces and
moments' "ut the simulator does not directly control the position of the
femoral component relati%e to the ti"ial component#17 -nstead' the femoral
and ti"ial components are free to mo%e relati%e to one another within con!
straints pro%ided "y the input forces and moments' the surface geometry of
each component' alignment of the components' friction "etween the articu!
lating surfaces' and soft!tissue restraints 3simulated "y springs5# &he limita!
tions of this second type of )nee joint simulator are that the position of the
femoral component as a function of fle+ion angle is not directly controlled
and that a larger num"er of inputs must "e selected for each test# Studies on
this second simulator type ha%e shown that implant design has a significant
independent effect on )inematics and wear22 and that wear de"ris generated
during wear tests of a )nee design match "oth the morphology and the si4e
of the particles retrie%ed from the )nee joints of patients with the same
implant design#2. @either type of )nee simulator' howe%er' has "een %alidat!
ed as demonstrati%e that the locations and type of wear damage o"ser%ed in
retrie%ed components can "e systematically recreated for a "road range of
161
-mplant Wear in &otal 1oint (eplacement
)nee designs' which may "e the only current means of %alidation# *ntil
methods are de%eloped to accurately measure clinical wear rates in total
)nee replacements' %alidation of )nee joint simulators on the "asis of match!
ing the clinical wear rate is impossi"le#
&here are many %ariations of test protocols emphasi4ing different
motions and the fre,uency of such motions as e+hi"ited "y human acti%ities#
&he correlations de%eloped "etween a particular test protocol and retrie%al
studies encompass "oth materials and design# Such correlations ta)e a long
time to de%elop unless early failures are o"ser%ed# As new materials and new
joint simulator test protocols continue to e%ol%e' such correlations necessarily
lag "ehind# &herefore' the philosophy of joint simulator testing is to o%er!
stress the materials and the design# &he use of the historical data"ase also
reinforces the effecti%eness of the materials and design e%aluations# As such'
joint simulator testing remains a main staple in today=s highly sophisticated
material e%aluation process#
A mechanistic understanding of wear pro%ides a framewor) for e%aluat!
ing different materials and designs# ;ach "earing material has indi%idual
characteristics and properties that reflect "oth its initial fa"rication and su"!
se,uent changes that might ha%e occurred in ser%ice# 2or e+ample' polyethy!
lene properties and wear characteristics will depend on the starting resin and
the method of fa"rication 3molding or e+trusion5' "ut may also "e affected
"y su"se,uent sterili4ation procedures' o+idati%e degradation' or crystalline
reorientation under dynamic and large joint contact loads#2/ When material
com"inations are used to form an artificial joint' the properties of the mate!
rial pair dominate the component performance# -n a long!term wear process'
the difference in material properties ultimately would result in different
degrees of wear# $ut not all material property differences would result in
o"ser%a"le or measura"le changes in wear in a short!term "ench wear test'
and "oth wear "ench tests and joint simulators can "e considered short!term
tests# What is the pro"a"ility that differences that are not appreciated in the
short term will amplify themsel%es after years of ser%ice in the "ody? -f a
series of controlled wear e+periments can "e conducted to elucidate the
"asic wear mechanisms under different loads' speeds' and lu"rication en%i!
ronments' a clear understanding will "e pro%ided for the material pair=s
"eha%ior# :ura"ility limits could then "e defined in terms of the test %ari!
a"les 3speed' load' and cycles to failure5# Often such results can "e compared
to an historical data"ase' increasing the pro"a"ility that drastic mista)es can
"e a%oided# (esults from e+tensi%e simulator testing can then pro%ide con!
firmation of the material pair=s performance for a gi%en geometric design
under a %ariety of operating conditions# With a clear understanding of wear
mechanisms pro%ided "y the "ench wear tests' an intelligent com"ination of
"ench wear testing and joint simulator studies pro%ides the "est practice in
today=s en%ironment#
162
aterial and :esign Considerations
(ele%ance
Wear and simulator testing are complicated tas)s# Controlled wear testing
should not "e routinely done to ,ualify a material' "ut rather to elucidate
wear mechanisms# Simulator tests' on the other hand' can "e used to conduct
accelerated protocols that replicateAsimulate particularly e+treme conditions'
there"y esta"lishing the limits of performance for the material# &he tas) is
complicated' howe%er' "y the lac) of understanding of the "asic wear mech!
anisms under a %ariety of operating conditions# 2or now' confidence in the
interpretation of wear testing data deri%es from successful correlation of
"ench test wear surfaces with retrie%ed implant surfaces in terms of surface
te+ture and wear de"ris si4e and shape#26
2uture :irections for (esearch
One of the critical issues in wear and joint simulator testing is how to e+trap!
olate short!term testing results to long!term projections# &his re,uires a solid
understanding of the relationship "etween material structures' properties'
and wear mechanisms# A carefully designed parameter study is needed to
systematically e+amine the influence of speed' loading cycles' and motion
directions on a material=s "eha%ior and the resulting wear phenomena#
any simulation issues are related to the polyethylene wear particle gen!
eration mechanisms under different wear testing conditions# 2urther
2igure / Controlled wear particle generation using surface te+turing and the resulting wear
particles#
16.
-mplant Wear in &otal 1oint (eplacement
research to esta"lish the relationship "etween wear particle si4e' shape' and
morphology and wear testing conditions is warranted# Sensiti%ity of "ioac!
ti%ity to particle si4e' shape' and morphology will pro%ide additional param!
eters to engineer the polymers for longer implant life#
$ecause wear particle si4e and shape are important parameters in defin!
ing the clinical rele%ance of wear tests and joint simulator tests' methods to
characteri4e different si4es and shapes are also needed# Current characteri!
4ation techni,ues lac) precision due to the lac) of suita"le' realistic standard
reference materials for instrument cali"ration and testing# &he technical
challenge to produce well controlled wear particles for such a purpose' how!
e%er' is highly comple+#
(ecent studies underta)en to de%elop controlled si4e and shape wear par!
ticles "y ru""ing ultra!high molecular weight polyethylene against a micro!
te+tured steel surface show promise#27!28 -f successful' this concept 32ig# /5
may produce uniformly si4ed wear particles of %arious shapes# -t also pro!
%ides insight into the "asic wear mechanisms' for e+ample how %arious si4es
and shapes of wear particles are produced under different wear conditions#
(eferences
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