A patterned microtexture to reduce friction and increase longevity of prosthetic hip joints.

More than 285,000 total hip replacement surgeries are performed in the US each year. Most prosthetic hip joints consist of a cobalt-chromium (CoCr) femoral head that articulates with a polyethylene acetabular component, lubricated with synovial fluid. The statistical survivorship of these metal-on-polyethylene prosthetic hip joints declines significantly after 10 to 15 years of use, primarily as a result of polyethylene wear and wear debris incited disease. The current engineering paradigm to increase the longevity of prosthetic hip joints is to improve the mechanical properties of the polyethylene component, and to manufacture ultra-smooth articulating surfaces. In contrast, we show that adding a patterned microtexture to the ultra-smooth CoCr femoral head reduces friction when articulating with the polyethylene acetabular liner. The microtexture increases the load-carrying capacity and the thickness of the joint lubricant film, which reduces contact between the articulating surfaces. As a result, friction and wear is reduced. We have used a lubrication model to design the geometry of the patterned microtexture, and experimentally demonstrate reduced friction for the microtextured compared to conventional smooth surrogate prosthetic hip joints.

Designing prosthetic knee joints with bio-inspired bearing surfaces.

It has long been known that articular cartilage exhibits a surface microtexture with shallow indentations. By contrast, prosthetic joints consist of ultra-smooth bearing surfaces, the longevity of which does not reach that of natural cartilage. We show that adding a microtexture to the smooth femoral component of a prosthetic knee joint reduces friction by increasing the lubricant film thickness between the bearing surfaces of the knee. We have implemented an elastohydrodynamic lubrication model to optimize the geometry of the microtexture, while taking into account the deformation of the polyethylene tibial insert. We have manufactured several microtexture designs on a surrogate femoral component, and experimentally demonstrate that the microtexture reduces friction between the surrogate femoral component and tibial insert.

Thin hard crest on the edge of ceramic acetabular liners accelerates wear in edge loading.

Ceramic acetabular liners may exhibit a small, sharp crest-an artifact of discontinuous machining steps--at the junction between the concave spherical surface and the interior edge. On 3 ceramic liners, this crest was found to form a 9° to 11° deviation from tangency. Edge loading wear tests were conducted directly on this crest and on a smoother region of the edge. The crest elicited 2 to 15 times greater volumetric wear on the femoral head. The propensity of the crest to rapidly (<2000 wear cycles) cause elevated wear under low contact force (200 N) suggests that the crest artifact of prevailing machining protocols might be a root cause of stripe wear and squeaking in ceramic acetabular bearings.

Determining a Surrogate Contact Pair in a Hertzian Contact Problem.

Laboratory testing of contact phenomena can be prohibitively expensive if the interacting bodies are geometrically complicated. This work demonstrates means to mitigate such problems by exploiting the established observation that two geometrically dissimilar contact pairs may exhibit the same contact mechanics. Specific formulas are derived that allow a complicated Hertzian contact pair to be replaced with an inexpensively manufactured and more easily fixtured surrogate pair, consisting of a plane and a spheroid, which has the same (to second-order accuracy) contact area and pressure distribution as the original complicated geometry. This observation is elucidated by using direct tensor notation to review a key assertion in Hertzian theory; namely, geometrically complicated contacting surfaces can be described to second-order accuracy as contacting ellipsoids. The surrogate spheroid geometry is found via spectral decomposition of the original pair's combined Hessian tensor. Some numerical examples using free-form surfaces illustrate the theory, and a laboratory test validates the theory under a common scenario of normally compressed convex surfaces. This theory for a Hertzian contact substitution may be useful in simplifying the contact, wear, or impact testing of complicated components or of their constituent materials.

An experimental approach to determining fatigue crack size in polyethylene tibial inserts.

A major limiting factor to the longevity of prosthetic knee joints is fatigue crack damage of the polyethylene tibial insert. Existing methods to quantify fatigue crack damage have several shortcomings, including limited resolution, destructive testing approach, and high cost. We propose an alternative fatigue crack damage visualization and measurement method that addresses the shortcomings of existing methods. This new method is based on trans-illumination and differs from previously described methods in its ability to non-destructively measure subsurface fatigue crack damage while using a simple and cost-effective bench-top set-up. We have evaluated this method to measure fatigue crack damage in two tibial inserts. This new method improves on existing image-based techniques due to its usability for subsurface damage measurement and its decreased reliance on subjective damage identification and measurement.

Using a surrogate contact pair to evaluate polyethylene wear in prosthetic knee joints.

With recent improvements to the properties of ultra-high molecular weight polyethylene (UHMWPE) used in joint replacements, prosthetic knee and hip longevity may extend beyond two decades. However, it is difficult and costly to replicate such a long in vivo lifetime using clinically relevant in vitro wear testing approaches such as walking gait joint simulators. We advance a wear test intermediate in complexity between pin-on-disk and knee joint simulator tests. The test uses a surrogate contact pair, consisting of a surrogate femoral and tibial specimen that replicate the contact mechanics of any full-scale knee condyle contact pair. The method is implemented in a standard multi-directional pin-on-disk wear test machine, and we demonstrate its application via a two-million-cycle wear test of three different UHMWPE formulations. Further, we demonstrate the use of digital photography and image processing to accurately quantify fatigue damage based on the reduced transmission of light through a damage area in a UHMWPE specimen. The surrogate contact pairs replicate the knee condyle contact areas within -3% to +12%. The gravimetric wear test results reflect the dose of crosslinking radiation applied to the UHMWPE: 35 kGy yielded a wear rate of 7.4 mg/Mcycles, 55 kGy yielded 1.0 mg/Mcycles, and 75 kGy (applied to a 0.1% vitamin E stabilized UHMWPE) yielded 1.5 mg/Mcycles. A precursor to spalling fatigue is observed and precisely measured in the radiation-sterilized (35 kGy) and aged UHMWPE specimen. The presented techniques can be used to evaluate the high-cycle fatigue performance of arbitrary knee condyle contact pairs under design-specific contact stresses, using existing wear test machines. This makes the techniques more economical and well-suited to standardized comparative testing.

A simple surrogate test method to rank the wear performance of prospective ceramic materials under hip prosthesis edge-loading conditions.

This research has developed a novel test method for evaluating the wear resistance of ceramic materials under severe contact stresses simulating edge loading in prosthetic hip bearings. Simply shaped test specimens - a cylinder and a spheroid - were designed as surrogates for an edge-loaded, head/liner implant pair. Equivalency of the simpler specimens was assured in the sense that their theoretical contact dimensions and pressures were identical, according to Hertzian contact theory, to those of the head/liner pair. The surrogates were fabricated in three ceramic materials: Al2 O3 , zirconia-toughened alumina (ZTA), and ZrO2 . They were mated in three different material pairs and reciprocated under a 200 N normal contact force for 1000-2000 cycles, which created small (<1 mm(2) ) wear scars. The three material pairs were ranked by their wear resistance, quantified by the volume of abraded material measured using an interferometer. Similar tests were performed on edge-loaded hip implants in the same material pairs. The surrogates replicated the wear rankings of their full-scale implant counterparts and mimicked their friction force trends. The results show that a proxy test using simple test specimens can validly rank the wear performance of ceramic materials under severe, edge-loading contact stresses, while replicating the beginning stage of edge-loading wear. This simple wear test is therefore potentially useful for screening and ranking new, prospective materials early in their development, to produce optimized candidates for more complicated full-scale hip simulator wear tests.

The effect of polyethylene creep on tibial insert locking screw loosening and back-out in prosthetic knee joints.

A prosthetic knee joint typically comprises a cobalt-chromium femoral component that articulates with a polyethylene tibial insert. A locking screw may be used to prevent micromotion and dislodgement of the tibial insert from the tibial tray. Screw loosening and back-out have been reported, but the mechanism that causes screw loosening is currently not well understood. In this paper, we experimentally evaluate the effect of polyethylene creep on the preload of the locking screw. We find that the preload decreases significantly as a result of polyethylene creep, which reduces the torque required to loosen the locking screw. The torque applied to the tibial insert due to internal/external rotation within the knee joint during gait could thus drive locking screw loosening and back-out. The results are very similar for different types of polyethylene.

Assessment of the applicability of the Hertzian contact theory to edge-loaded prosthetic hip bearings.

The components of prosthetic hip bearings may experience in-vivo subluxation and edge loading on the acetabular socket as a result of joint laxity, causing abnormally high, damaging contact stresses. In this research, edge-loaded contact of prosthetic hips is examined analytically and experimentally in the most commonly used categories of material pairs. In edge-loaded ceramic-on-ceramic hips, the Hertzian contact theory yields accurate (conservatively, <10% error) predictions of the contact dimensions. Moreover, the Hertzian theory successfully captures slope and curvature trends in the dependence of contact patch geometry on the applied load. In an edge-loaded ceramic-on-metal pair, a similar degree of accuracy is observed in the contact patch length; however, the contact width is less accurately predicted due to the onset of subsurface plasticity, which is predicted for loads >400N. The Hertzian contact theory is shown to be ill-suited to edge-loaded ceramic-on-polyethylene pairs due to polyethylene's nonlinear material behavior. This work elucidates the methods and the accuracy of applying classical contact theory to edge-loaded hip bearings. The results help to define the applicability of the Hertzian theory to the design of new components and materials to better resist severe edge loading contact stresses.