ArticleInternational orthopaedics2015
In vitro effects on mobile polyethylene insert under highly demanding daily activities: stair climbing.
Article in International orthopaedics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Chemical, Mechanical and Tribological Effects of Artificially Aging up to 6 Weeks on Virgin and Crosslinked UHMWPE Evaluated for a TKR Design.Bioengineering (Basel, Switzerland) · 2025Article
- Introduction of innovations in joint arthroplasty: Recommendations from the 'EFORT implant and patient safety initiative'.EFORT open reviews · 2023Review
- Preliminary In Vitro Wear Assessment of Ceramic Cemented Femoral Components Coupled with Polyethylene Menisci.Materials (Basel, Switzerland) · 2021Article
- Knee Wear Assessment: 3D Scanners Used as a Consolidated Procedure.Materials (Basel, Switzerland) · 2020Article
- A Critical Analysis of TKR In Vitro Wear Tests Considering Predicted Knee Joint Loads.Materials (Basel, Switzerland) · 2019Article
- Quantification of Wear and Deformation in Different Configurations of Polyethylene Acetabular Cups Using Micro X-ray Computed Tomography.Materials (Basel, Switzerland) · 2017Article
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Authors and funding
5 authors.
Funding
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Abstract
purposeWear and survival of total joint replacements do not depend on the duration of the implant in situ, but rather on the amount of its use, i.e. the patient's activity level. With this in mind, the present study was driven by two questions: (1) How does total knee replacement (TKR) respond to the simulation of daily highly demanding activities? (2) Are certain activities to be advised against or, on the contrary, useful to implanted patients, in order to reduce wear of TKR and its related problems?
methodsOne set of the same total knee prosthesis (TKP), equal in design and size, was tested on a three-plus-one knee joint simulator for two million cycles using a highly demanding daily load waveform, replicating a stair-climbing movement. The results were compared with a set of TKP previously tested with the ISO level walking task. A digital microscope was used to characterise the superficial structure of all the TKPs. Gravimetric and micro-Raman spectroscopic analyses were carried out on the polyethylene inserts. Visual comparison with in vivo explants was carried out.
resultsThe average volumetric mass loss after two million cycles was 44 ± 6 mm(3). Microscope examinations showed some deep scratches along the flexion/extension movements for all the components. Also, the metallic backside surface showed intense non-linear scratches and the polyethylene counterface was characterised by some craters. A decrease in crystallinity, induced by mechanical stress was observed on all polyethylene components and was quantitatively confirmed by the orthorhombic fraction αo value.
conclusionsThe results of this study demonstrated that the forces and motion sustained by the knee are highly activity-dependent. Moreover, this test confirmed that under more severe conditions, the material properties change according to a different wear mechanism and a decrease in crystallinity occurs. Loading characteristics for specific activities should be considered for the design of functional and robust TKRs.
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