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International Orthopaedics

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01-07-2015 | Original Paper

In vitro effects on mobile polyethylene insert under highly demanding daily activities: stair climbing

Authors: Sami Abdel Jaber, Paola Taddei, Silvia Tozzi, Alessandra Sudanese, Saverio Affatato

Published in: International Orthopaedics | Issue 7/2015

Abstract

Purpose

Wear and survival of total joint replacements do not depend on the duration of the implant in situ, but rather on the amount of its use, i.e. the patient’s activity level. With this in mind, the present study was driven by two questions: (1) How does total knee replacement (TKR) respond to the simulation of daily highly demanding activities? (2) Are certain activities to be advised against or, on the contrary, useful to implanted patients, in order to reduce wear of TKR and its related problems?

Methods

One set of the same total knee prosthesis (TKP), equal in design and size, was tested on a three-plus-one knee joint simulator for two million cycles using a highly demanding daily load waveform, replicating a stair-climbing movement. The results were compared with a set of TKP previously tested with the ISO level walking task. A digital microscope was used to characterise the superficial structure of all the TKPs. Gravimetric and micro-Raman spectroscopic analyses were carried out on the polyethylene inserts. Visual comparison with in vivo explants was carried out.

Results

The average volumetric mass loss after two million cycles was 44 ± 6 mm³. Microscope examinations showed some deep scratches along the flexion/extension movements for all the components. Also, the metallic backside surface showed intense non-linear scratches and the polyethylene counterface was characterised by some craters. A decrease in crystallinity, induced by mechanical stress was observed on all polyethylene components and was quantitatively confirmed by the orthorhombic fraction α_o value.

Conclusions

The results of this study demonstrated that the forces and motion sustained by the knee are highly activity-dependent. Moreover, this test confirmed that under more severe conditions, the material properties change according to a different wear mechanism and a decrease in crystallinity occurs. Loading characteristics for specific activities should be considered for the design of functional and robust TKRs.

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Title: In vitro effects on mobile polyethylene insert under highly demanding daily activities: stair climbing
Authors: Sami Abdel Jaber
Paola Taddei
Silvia Tozzi
Alessandra Sudanese
Saverio Affatato
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 7/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-014-2622-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

In vitro effects on mobile polyethylene insert under highly demanding daily activities: stair climbing

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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