Kang Kyoung-Tak, Son Juhyun, Kim Ho-Joong, Baek Changhyun, Kwon Oh-Ryong, Koh Yong-Gon
Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
J Mater Sci Mater Med. 2017 Jul;28(7):105. doi: 10.1007/s10856-017-5916-5. Epub 2017 May 22.
The wear of ultrahigh-molecular weight polyethylene (UHMWPE) tibial inserts in total knee arthroplasty (TKA) remains a major limitation that hinders the longevity of clinically successful devices. Surface properties significantly affect the overall performance of TKA, and surface modification with mechanically and chemically stable materials is an effective method for overcoming the wear of TKA. However, wear tests are not cost-efficient or time-efficient; thus, the effects of geometric, loading, and alignment perturbations are often evaluated via parametric studies. Computational wear prediction using a finite element (FE) model followed by validation through comparison with experimental data is effective for assessing new prosthetic designs or surface change methods prior to functional testing and surgical implementation. The aim of this study was to evaluate the weight loss, wear depth, and kinematics for different surface properties, including nanostructured diamond (NSD), diamond-like carbon (DLC), titanium-nitride (TiN), and oxidized zirconium (OxZr) on femoral components in TKA using FE analysis under gait-cycle loading conditions. Weight loss and wear depth were lowest with OxZr followed by TiN, NSD, and DLC. However, the DLC femoral component did not show any improvement in wear rate compared to an uncoated cobalt-chromium (Co-Cr) femoral component. Not all surface changes applied in this study did lead to improvement in wear performance. However, this study demonstrates the potential of OxZr and TiN for reducing UHMWPE wear and offers new insights into the effects of wear on TKA.
全膝关节置换术（TKA）中超高分子量聚乙烯（UHMWPE）胫骨假体的磨损仍然是一个主要限制因素，阻碍了临床成功植入装置的长期使用。表面特性显著影响TKA的整体性能，使用机械和化学稳定材料进行表面改性是克服TKA磨损的有效方法。然而，磨损测试既不经济也不省时；因此，几何、载荷和对线扰动的影响通常通过参数研究来评估。在功能测试和手术实施之前，使用有限元（FE）模型进行计算磨损预测，然后通过与实验数据比较进行验证，对于评估新的假体设计或表面改变方法是有效的。本研究的目的是在步态周期加载条件下，使用有限元分析评估TKA中股骨部件上不同表面特性（包括纳米结构金刚石（NSD）、类金刚石碳（DLC）、氮化钛（TiN）和氧化锆（OxZr））的重量损失、磨损深度和运动学。OxZr的重量损失和磨损深度最低，其次是TiN、NSD和DLC。然而，与未涂层的钴铬（Co-Cr）股骨部件相比，DLC股骨部件的磨损率没有任何改善。并非本研究中应用的所有表面改变都能改善磨损性能。然而，本研究证明了OxZr和TiN在减少UHMWPE磨损方面的潜力，并为磨损对TKA的影响提供了新的见解。
