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Lubricants 2017, 5(3), 25;

Conventional and Highly Crosslinked Polyethylene in Total Knee Arthroplasty—A Design-Independent Wear Investigation

Department of Orthopedic Surgery, University Hospital of Munich (LMU), Campus Grosshadern, 81377 Munich, Germany
Author to whom correspondence should be addressed.
Academic Editor: J. Paulo Davim
Received: 31 May 2017 / Revised: 7 July 2017 / Accepted: 10 July 2017 / Published: 16 July 2017
(This article belongs to the Special Issue Tribological Performance of Artificial Joints 2017)
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Introduction: Improvement of total knee arthroplasty (TKA) materials is one promising approach for extending the lifetime of endoprostheses. The target of this study was to evaluate the sufficiency of TKA-design-independent rolling–sliding screening tests. Additionally, this study attempted to assess the relevance of the design of TKA systems for wear performance by comparison with a simulator study. Materials and Methods: A TKA-design-independent rolling–sliding testing machine was employed at ISO (the International Organization for Standardization) 14243-near conditions and physiologic level unidirectional rolling–sliding. Contact surfaces were generalized into elementary forms at curvatures of real endoprostheses: CoCr-cylinders on flat UHMWPE (ultra-high-molecular-weight-polyethylene) cuboids. Materials varied in resin and crosslinking. One conventional UHMWPE and three highly crosslinked polyethylenes were charged with an axial load of 2.5 kN for 5 million cycles. Wear was determined gravimetrically and the ranking was compared to a simulator study. Results: No statistically significant differences between either material were found. This was inconsistent with the results of a simulator survey. Conclusions: The results of the study indicate that this type of screening test is not able to correctly rank UHMWPE for use in TKA systems. The use of a UHMWPE plate in the test setup with a rolling–sliding cylinder is capable of producing visible wear marks in the bearing area, but the setup followed by a gravimetric measurement does not show reliable results. As the tested materials did not significantly vary in wear performance, it can be concluded that for differences in TKA wear-production, the design of TKR-systems can matter. View Full-Text
Keywords: rolling–sliding; UHMWPE; crosslinking; TKA; wear; debris; simulator rolling–sliding; UHMWPE; crosslinking; TKA; wear; debris; simulator

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Paulus, A.C.; Woicinzski, M.; Jansson, V.; Utzschneider, S. Conventional and Highly Crosslinked Polyethylene in Total Knee Arthroplasty—A Design-Independent Wear Investigation. Lubricants 2017, 5, 25.

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