McKellop Harry A, D'Lima Darryl
Department of Orthopaedic Surgery, UCLA-Orthopaedic Hospital, Los Angeles, CA, USA.
J Am Acad Orthop Surg. 2008;16 Suppl 1:S111-9. doi: 10.5435/00124635-200800001-00022.
Historically, hip joint simulators most often have been used to model wear of a bearing surface against a bearing surface. These simulators have provided highly accurate predictions of the in vivo wear of a broad spectrum of bearing materials, including cross-linked polyethylenes, metal-on-metal, ceramic-on-ceramic, and others in development. In recent years, more severe conditions have been successfully modeled, including jogging, stair climbing, ball-cup micro separation, third-body abrasion, and neck-socket impingement. These tests have served to identify improved materials and to eliminate some with inadequate wear resistance prior to their clinical use. Simulation of the knee joint is inherently more complex than it is for the hip. It is more difficult to compare the results of laboratory tests with actual clinical performance, due to the lack of accurate in vivo measures of wear. Nevertheless, knee simulators, based on force control or motion control, have successfully reproduced the type of surface damage that occurs in vivo (eg, burnishing, scratching, pitting) as well as the size and shapes of the resultant wear particles. Knee simulators have been used to compare molded versus machined polyethylene components, highly cross-linked polyethylenes, fixed versus mobile bearings, and oxidized zirconia and other materials, under optimal conditions as well as more severe wear modes, such as malalignment, higher loading and activity levels, and third-body roughening.
从历史上看，髋关节模拟器最常用于模拟一个轴承表面相对于另一个轴承表面的磨损情况。这些模拟器已经能够对多种轴承材料的体内磨损进行高度准确的预测，这些材料包括交联聚乙烯、金属对金属、陶瓷对陶瓷以及其他正在研发的材料。近年来，人们已经成功模拟了更严苛的条件，包括慢跑、爬楼梯、球窝微分离、三体磨损以及头颈撞击。这些测试有助于识别性能更优的材料，并在临床应用前淘汰一些耐磨性不足的材料。膝关节的模拟本质上比髋关节更复杂。由于缺乏对磨损的准确体内测量，将实验室测试结果与实际临床性能进行比较更加困难。尽管如此，基于力控制或运动控制的膝关节模拟器已经成功再现了体内出现的表面损伤类型（如抛光、刮擦、点蚀）以及由此产生的磨损颗粒的大小和形状。膝关节模拟器已被用于在最佳条件以及更严苛的磨损模式（如排列不齐、更高的负荷和活动水平以及三体粗糙化）下比较模制与机械加工的聚乙烯部件、高度交联的聚乙烯、固定轴承与活动轴承以及氧化锆和其他材料。
