Smith S L, Ash H E, Unsworth A
Centre for Biomedical Engineering, University of Durham, Durham, DH1 3LE, England, UK.
J Biomed Mater Res. 2000;53(6):710-6. doi: 10.1002/1097-4636(2000)53:6<710::aid-jbm14>3.0.co;2-r.
A novel design of polyurethane compliant layer acetabular cup has been developed through a series of friction, creep and wear tests. Friction tests were initially conducted on ABG standard form, polyurethane acetabular cups and an ABG standard form, UHMWPE acetabular cup for comparison. The polyurethane cups showed lower friction than the UHMWPE cup with maximum friction factors between 0. 008 and 0.02 compared with 0.035 for the UHMWPE cup. This indicated that, in the polyurethane cups, more of the load across the joint was carried by the fluid entrapped in the joint space rather than with asperity contact, compared with the UHMWPE cup. The inherent compliance of the polyurethane is used to promote elasto-hydrodynamic lubrication. However, this compliance raised concerns over excessive creep, which may in turn adversely affect tribological performance. Therefore, creep tests were undertaken on the ABG standard form, polyurethane acetabular cups followed by further friction tests. Small amounts of creep occurred in the polyurethane cups at ambient temperature, which reduced the friction slightly (maximum friction factors of 0.009) due to increased conformity between the head and the cup. However, at 37 degrees C, greater creep occurred causing pinching of the femoral head by the acetabular cup resulting in lubricant starvation and higher friction (maximum friction factors of 0.035). The design of the polyurethane cups was subsequently modified to incorporate a flared rim to eliminate the possibility of fluid starvation through pinching. Creep in polyurethane acetabular cups is also affected by the method of fixation of the cups, due to the conformity with and the stiffness of the cup backing. Hence, a one-million-cycle wear test was performed on five ABG flared form, polyurethane acetabular cups on the Mk. I Durham Hip Joint Wear Simulator to evaluate the best method of fixation for the polyurethane cups. The smallest amount of penetration, due to creep and wear, was found with cement fixation (0.30 mm penetration with cement fixation, 0.44 mm with polyethylene holder mounting, and 0.52 mm with metal shell mounting). A 4. 25-million-cycle wear test was then conducted on a further five ABG flared form, polyurethane acetabular cups with cement fixation. Five ABG standard form, UHMWPE acetabular cups were also wear-tested to 5. 0-million cycles. The mean and standard error of the wear rate for the polyurethane cups were 14.1 +/- 4.3 mg/10(6) (12.0 +/- 3.6 mm(3)/10(6)), cycles compared with 44.8 +/- 3.4 mg/10(6) (48.2 +/- 3. 7 mm(3)/10(6)), cycles for the UHMWPE cups. This study showed that the novel polyurethane-compliant layer acetabular cup with cement fixation was tribologically superior to the ABG standard form UHMWPE design currently being used clinically.
通过一系列摩擦、蠕变和磨损试验,研发出了一种新型的聚氨酯顺应性衬层髋臼杯。最初对ABG标准型聚氨酯髋臼杯以及一个ABG标准型超高分子量聚乙烯(UHMWPE)髋臼杯进行摩擦试验以作比较。聚氨酯杯的摩擦力低于UHMWPE杯,其最大摩擦系数在0.008至0.02之间,而UHMWPE杯的最大摩擦系数为0.035。这表明,与UHMWPE杯相比,在聚氨酯杯中,关节上的更多负荷由关节间隙中截留的液体承载,而非通过粗糙面接触承载。聚氨酯的固有顺应性用于促进弹流润滑。然而,这种顺应性引发了对过度蠕变的担忧,过度蠕变可能反过来对摩擦学性能产生不利影响。因此,对ABG标准型聚氨酯髋臼杯进行了蠕变试验,随后又进行了进一步的摩擦试验。聚氨酯杯在环境温度下出现少量蠕变,这由于股骨头与髋臼杯之间贴合度增加而使摩擦力略有降低(最大摩擦系数为0.009)。然而,在37摄氏度时,出现了更大的蠕变,导致髋臼杯挤压股骨头,造成润滑剂供应不足以及摩擦力增大(最大摩擦系数为0.035)。随后对聚氨酯杯的设计进行了修改,加入了扩口边缘,以消除因挤压导致润滑剂供应不足的可能性。聚氨酯髋臼杯的蠕变还受髋臼杯固定方法的影响,这是由于与髋臼杯衬背的贴合度及刚度所致。因此,在Mk. I达勒姆髋关节磨损模拟器上对五个ABG扩口型聚氨酯髋臼杯进行了一百万次循环的磨损试验,以评估聚氨酯杯的最佳固定方法。发现采用骨水泥固定时,因蠕变和磨损导致的穿透量最小(骨水泥固定时穿透0.30毫米,聚乙烯固定架安装时穿透0.44毫米,金属壳安装时穿透0.52毫米)。然后对另外五个采用骨水泥固定的ABG扩口型聚氨酯髋臼杯进行了425万次循环的磨损试验。还对五个ABG标准型UHMWPE髋臼杯进行了500万次循环的磨损试验。聚氨酯杯磨损率的平均值和标准误差为14.1±4.3毫克/10⁶(12.0±3.6立方毫米/10⁶次循环),而UHMWPE杯的磨损率为44.8±3.4毫克/10⁶(48.2±3.7立方毫米/10⁶次循环)。这项研究表明,采用骨水泥固定的新型聚氨酯顺应性衬层髋臼杯在摩擦学性能上优于目前临床使用的ABG标准型UHMWPE设计。