David C. Barton

Comparison of wear, wear debris and functional biological activity of moderately crosslinked and non-crosslinked polyethylenes in hip prostheses

Abstract The wear, wear debris and functional biological activity of non-crosslinked and moderately crosslinked ultrahigh molecular weight polyethylene (UHMWPE) acetabular cups have been compared when articulating against smooth and intentionally scratched femoral heads. Volumetric wear rates were determined in a hip joint simulator and the debris was isolated from the lubricant and characterized by the percentage number and volumetric concentration as a function of particle size. The volumetric concentration was integrated with the biological activity function determined from in vitro cell culture studies to predict an index of specific biological activity (SBA). The product of specific biological activity and volumetric wear rate was used to determine the index of functional biological activity (FBA). On smooth femoral heads the crosslinked UHMWPE had a 30 per cent lower wear rate, but it had a greater percentage volume of smaller, more biologically active particles, which resulted in a similar index of FBA compared with the non-crosslinked material. On the scratched femoral heads the volumetric wear rate was three times higher for the moderately crosslinked UHMWPE and two times higher for the non-crosslinked UHMWPE compared with the smooth femoral heads. This resulted in a higher wear rate for the moderately crosslinked material on the scratched femoral heads. All the differences in wear rate were statistically significant. There were only small differences in particle volume concentration distributions, and this resulted in similar indices of FBA which were approximately twice the values of those found on the smooth femoral heads. Both materials showed lower wear and FBA than for previously studied aged and oxidized UHMWPE gamma irradiated in air. However, this study did not reveal any advantage in terms of predicted FBA for moderately crosslinked UHMWPE compared with non-crosslinked UHMWPE.

A Dynamic Study of Thoracolumbar Burst Fractures

BACKGROUND The degree of canal stenosis following a thoracolumbar burst fracture is sometimes used as an indication for decompressive surgery. This study was performed to test the hypothesis that the final resting positions of the bone fragments seen on computed tomography imaging are not representative of the dynamic canal occlusion and associated neurological damage that occurs during the fracture event. METHODS A drop-weight method was used to create burst fractures in bovine spinal segments devoid of a spinal cord. During impact, dynamic measurements were made with use of transducers to measure pressure in a synthetic spinal cord material, and a high-speed video camera filmed the inside of the spinal canal. A corresponding finite element model was created to determine the effect of the spinal cord on the dynamics of the bone fragment. RESULTS The high-speed video clearly showed the fragments of bone being projected from the vertebral body into the spinal canal before being recoiled, by the action of the posterior longitudinal ligament and intervertebral disc attachments, to their final resting position. The pressure measurements in the synthetic spinal cord showed a peak in canal pressure during impact. There was poor concordance between the extent of postimpact occlusion of the canal as seen on the computed tomography images and the maximum amount of occlusion that occurred at the moment of impact. The finite element model showed that the presence of the cord would reduce the maximum dynamic level of canal occlusion at high fragment velocities. The cord would also provide an additional mechanism by which the fragment would be recoiled back toward the vertebral body. CONCLUSIONS A burst fracture is a dynamic event, with the maximum canal occlusion and maximum cord compression occurring at the moment of impact. These transient occurrences are poorly related to the final level of occlusion as demonstrated on computed tomography scans.

A dynamic investigation of the burst fracture process using a combined experimental and finite element approach

Spinal burst fractures account for about 15% of spinal injuries and, because of their predominance in the younger population, there are large associated social and healthcare costs. Although several experimental studies have investigated the burst fracture process, little work has been undertaken using computational methods. The aim of this study was to develop a finite element model of the fracture process and, in combination with experimental data, gain a better understanding of the fracture event and mechanism of injury. Experimental tests were undertaken to simulate the burst fracture process in a bovine spine model. After impact, each specimen was dissected and the severity of fracture assessed. Two of the specimens tested at the highest impact rate were also dynamically filmed during the impact. A finite element model, based on CT data of an experimental specimen, was constructed and appropriate high strain rate material properties assigned to each component. Dynamic validation was undertaken by comparison with high-speed video data of an experimental impact. The model was used to determine the mechanism of fracture and the postfracture impact of the bony fragment onto the spinal cord. The dissection of the experimental specimens showed burst fractures of increasing severity with increasing impact energy. The finite element model demonstrated that a high tensile strain region was generated in the posterior of the vertebral body due to the interaction of the articular processes. The region of highest strain corresponded well with the experimental specimens. A second simulation was used to analyse the fragment projection into the spinal canal following fracture. The results showed that the posterior longitudinal ligament became stretched and at higher energies the spinal cord and the dura mater were compressed by the fragment. These structures deformed to a maximum level before forcing the fragment back towards the vertebral body. The final position of the fragment did not therefore represent the maximum dynamic canal occlusion.

The influence of stress conditions on the wear of UHMWPE for total joint replacements

In vitro studies of the effect of contact stress on the wear of ultra high molecular weight polyethylene (UHMWPE) in orthopaedic applications have produced contradictory results which predict both increased and decreased wear with increasing contact stress. In vivo studies of functioning hip prostheses have reported that 22 mm femoral heads generate lower linear and volumetric wear rates than 32 mm femoral heads. The effect of decreasing the head size will increase the contact stress but decrease the sliding distance per motion cycle. The present study consists of wear experiments under a range of contact stress magnitudes and application conditions in order to simulate the wear processes occurring in vivo. The results from these tests indicated that the wear factor actually decreases with increasing contact stress if the stress was not varied with time. If a time dependent or spatially varying stress was applied, the wear factor can increase greatly when compared to similar magnitude constant contact stress. This effect may be due to the complex relationship between the rate of wear particle generation and the rate at which the particles are released from the interface. The results of these wear experiments are discussed in terms of the influence of the stress conditions upon potential wear processes in total hip and knee prostheses.

Bilevel Optimization of Blended Composite Wing Panels

Two approaches are examined for finding the best stacking sequence of laminated composite wing structures with blending and manufacturing constraints: smeared-stiffness-based method and lamination-parameter-based method. In the firstmethod, thematerial volume is the objective function at the global level, and the stack shuffling to satisfy blending and manufacturing constraints is performed at the local level. The other method introduced in this paper is to use lamination parameters and numbers of plies of the predefined angles (0, 90, 45, and 45 deg) as design variables with buckling, strain, and ply percentage constraints while minimizing the material volume in the top-level optimization run.Given lamination parameters from the top-level optimization as targets for the local level, an optimal stacking sequence is determined to satisfy the global blending requirements. On a benchmark problem of an 18-panel wing box, the results from these two approaches are compared to published results to demonstrate their potential.

Comparative wear under four different tribological conditions of acetylene enhanced cross-linked ultra high molecular weight polyethylene.

In this study, the wear of ultra high molecular weight polyethylene (UHMWPE) (Grade RCH 1000) crosslinked by gamma irradiation in acetylene was compared to virgin (non-irradiated) UHMWPE using four different wear configurations: (i) unidirectional motion with a smooth counterface, (ii) multidirectional motion with a smooth counterface, (iii) unidirectional motion with a rough counterface and (iv) multidirectional motion with a rough counterface. ©©1999©Kluwer Academic Publishers

Measurement of canal occlusion during the thoracolumbar burst fracture process

Post-injury CT scans are often used following burst fracture trauma as an indication for decompressive surgery. Literature suggests, however, that there is little correlation between the observed fragment position and the level of neurological injury or recovery. Several studies have aimed to establish the processes that occur during the fracture using indirect methods such as pressure measurements and pre/post impact CT scans. The purpose of this study was to develop a direct method of measuring spinal canal occlusion during a simulated burst fracture by using a high-speed video technique. The fractures were produced by dropping a mass from a measured height onto three-vertebra bovine specimens in a custom-built rig. The specimens were constrained to deform only in the impact direction such that pure compression fractures were generated. The spinal cord was removed prior to testing and the video system set up to film the inside of the spinal canal during the impact. A second camera was used to film the outside of the specimen to observe possible buckling during impact. The video images were analysed to determine how the cross-sectional area of the spinal canal changed during the event. The images clearly showed a fragment of bone being projected from the vertebral body into the spinal canal and recoiling to the final resting position. To validate the results, CT scans were taken pre- and post-impact and the percentage canal occlusion was calculated. There was good agreement between the final canal occlusion measured from the video images and the CT scans.

Comparison of gas plasma and gamma irradiation in air sterilization on the delamination wear of the ultra-high molecular weight polyethylene used in knee replacements.

Abstract Early failure of knee replacements is thought to be due to the combination of sterilization by gamma irradiation in air and the high cyclic stresses that they endure during use. Such failures are shown through delamination and permanent deformation of the ultra-high molecular weight polyethylene (UHMWPE) component. This study investigated whether gas plasma sterilization, as an alternative to gamma irradiation in air, would give better performance after ageing in a knee replacement using a metal pin on polymer plate wear test. Fourier transform infrared (FTIR) analysis was performed on the components to assess oxidation levels and a finite element stress analysis model is presented to estimate strain at failure in the UHMWPE. Delamination occurred in the majority of the gamma-irradiated plates but did not occur in any of the gas-plasma-sterilized plates. The FTIR analysis showed that the plates gamma irradiated in air were highly oxidized when compared with the gas-plasma-sterilized plates. Plastic strain at failure was determined for the gamma-irradiated plates and found to be less than 2.4-14 per cent.

The prediction of polyethylene wear rate and debris morphology produced by microscopic asperities on femoral heads

Counterface damage in the form of scratches, caused by bone cement, bone or metallic particles, has been cited as a cause of increased wear of ultra-high molecular weight polyethylene (UHMWPE) acetabular cups. It is known that high levels of particulate wear debris lead to osteolysis. Surface damage was characterized in a series of explanted Charnley femoral heads. The heads had a mean scratch height of 1 μm with a mean aspect ratio (defined as height divided by half width) of 0.1. Wear discs were artificially scratched using these scratch geometries as a guide. In addition, the scratch geometries were incorporated into a finite element model of a stainless steel asperity repeatedly sliding over UHMWPE under conditions similar to those in an artificial hip joint. Wear tests showed a strong correlation between the average cross-sectional area of the scratch lip above the mean zero line and the measured wear factor. The finite element model predicted increases in the area of UHMWPE suffering plastic strain with increases in the cross-sectional area of the asperity above the mean line. Analysis of the wear debris showed the mode of the particle size was 0.01–0.5 μm for all cases. The morphology of the particles varied with aspect ratio of the asperity, with an increased percentage mass of submicrometer-sized debris with increased scratch lip aspect ratio. The finite element results predicted that the maximum surface strains would increase with increasing asperity aspect ratio. Examination of the worn UHMWPE pin surfaces showed an association between increased surface damage, probably due to high surface strains, and increased aspect ratio. The large areas of surface plastic strain predicted for asperities with high cross-sectional areas above the mean line offer an explanation for the positive correlation between wear rate and the average cross-sectional area of the scratch lip material. The higher surface strains predicted for the higher aspect ratios may explain the increased percentage mass of biologically active submicrometer-sized wear particles found for scratch lips with higher aspect ratios. ©©2000 Kluwer Academic Publishers

Development of a bovine collagen-apatitic calcium phosphate cement for potential fracture treatment through vertebroplasty.

The aim of this study was to examine the potential of incorporating bovine fibres as a means of reinforcing a typically brittle apatite calcium phosphate cement for vertebroplasty. Type I collagen derived from bovine Achilles tendon was ground cryogenically to produce an average fibre length of 0.96±0.55 mm and manually mixed into the powder phase of an apatite-based cement at 1, 3 or 5 wt.%. Fibre addition of up to 5 wt.% had a significant effect (P ≤ 0.001) on the fracture toughness, which was increased by 172%. Adding ≤ 1 wt.% bovine collagen fibres did not compromise the compressive properties significantly, however, a decrease of 39-53% was demonstrated at ≥ 3wt.% fibre loading. Adding bovine collagen to the calcium phosphate cement reduced the initial and final setting times to satisfy the clinical requirements stated for vertebroplasty. The cement viscosity increased in a linear manner (R²=0.975) with increased loading of collagen fibres, such that the injectability was found to be reduced by 83% at 5 wt.% collagen loading. This study suggests for the first time the potential application of a collagen-reinforced calcium phosphate cement as a viable option in the treatment of vertebral fractures, however, issues surrounding efficacious cement delivery need to be addressed.