Nelson Brody K, Nazzal Ehab M, Moody Devon, Jakucki Maciej, Kaufmann Robert A
Element Materials Technology, Fairfield, OH, USA.
Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh PA, USA.
J Shoulder Elbow Surg. 2025 Apr;34(4):1088-1097. doi: 10.1016/j.jse.2024.07.015. Epub 2024 Aug 28.
The objective of this study was to perform a polyethylene wear test on a nonmechanically linked total elbow arthroplasty implant using a clinically relevant in-vitro elbow wear test methodology that simulated 10 years of use in the light to moderate activity of daily living range.
The test protocol applied an 80° arc of ulnohumeral motion beginning at 30° shy of full extension and progressing to 110° of flexion. Force was applied at 7° to recreate a valgus load on the elbow. A variable joint load profile at a frequency of 0.5 Hz was employed. The implants were tested for 5 million cycles (mc) in a bovine serum lubricant. Implant component failure was characterized and polyethylene wear was determined gravimetrically.
After 5 mc, the small polyethylene bushing wear rate was 0.56 mg/mc. The medium size wear rate was 0.28 mg/mc. Three large sizes were tested and the average wear rate was 0.39 ± 0.07 mg/mc. No implant failure was identified.
The test recreated an in vivo loading environment and measured polyethylene wear rates at specified cycle counts. The test demonstrated less wear than other joint replacements. Further clinical evaluation is necessary to determine if this translates into reduced complications of total elbow replacement associated with wear.
本研究的目的是使用一种临床相关的体外肘关节磨损测试方法，对一种非机械连接的全肘关节置换植入物进行聚乙烯磨损测试，该方法模拟了在轻度至中度日常生活活动范围内10年的使用情况。
测试方案采用从完全伸展前30°开始至屈曲110°的80°尺肱运动弧。在7°施加力以在肘关节上重现外翻负荷。采用频率为0.5Hz的可变关节负荷曲线。植入物在牛血清润滑剂中进行500万次循环（mc）测试。对植入物部件的失效进行表征，并通过重量法测定聚乙烯磨损情况。
500万次循环后，小尺寸聚乙烯衬套的磨损率为0.56mg/mc。中等尺寸的磨损率为0.28mg/mc。测试了三个大尺寸，平均磨损率为0.39±0.07mg/mc。未发现植入物失效。
该测试重现了体内加载环境，并在指定的循环次数下测量了聚乙烯磨损率。该测试显示的磨损比其他关节置换物少。需要进一步的临床评估来确定这是否会转化为全肘关节置换中与磨损相关的并发症减少。
