[Tribology in arthroplasty : Friction and wear, a key to a long lifetime]. / Tribologie in der Endoprothetik : Reibung und Verschleiß, ein Schlüssel zu langen Standzeiten.

This article is intended to highlight one of the key roles in endoprosthetic treatment with artificial implants and the extension of service life. Like every joint, artificial joints are subject to the physical laws of friction and wear-in short, tribology. Material pairings, surfaces and mechanisms of action in particular play a decisive role here. The special features and current findings relating to the three largest synovial joints (hip, knee and shoulder) will be discussed in detail and suggestions will be made for future developments. Continuous developments in the field of the tribology of artificial joints can massively improve care for patients. The revision figures and reasons already show the success of individual improvements in recent years.

Subject-specific tribo-contact conditions in total knee replacements: a simulation framework across scales.

Fundamental knowledge about in vivo kinematics and contact conditions at the articulating interfaces of total knee replacements are essential for predicting and optimizing their behavior and durability. However, the prevailing motions and contact stresses in total knee replacements cannot be precisely determined using conventional in vivo measurement methods. In silico modeling, in turn, allows for a prediction of the loads, velocities, deformations, stress, and lubrication conditions across the scales during gait. Within the scope of this paper, we therefore combine musculoskeletal modeling with tribo-contact modeling. In the first step, we compute contact forces and sliding velocities by means of inverse dynamics approach and force-dependent kinematic solver based upon experimental gait data, revealing contact forces during healthy/physiological gait of young subjects. In a second step, the derived data are employed as input data for an elastohydrodynamic model based upon the finite element method full-system approach taking into account elastic deformation, the synovial fluid's hydrodynamics as well as mixed lubrication to predict and discuss the subject-specific pressure and lubrication conditions.

Amorphous Carbon Coatings for Total Knee Replacements-Part I: Deposition, Cytocompatibility, Chemical and Mechanical Properties.

Diamond-like carbon (DLC) coatings have the potential to reduce implant wear and thus to contribute to avoiding premature failure and increase service life of total knee replacements (TKAs). This two-part study addresses the development of such coatings for ultrahigh molecular weight polyethylene (UHMWPE) tibial inlays as well as cobalt-chromium-molybdenum (CoCr) and titanium (Ti64) alloy femoral components. While a detailed characterization of the tribological behavior is the subject of part II, part I focusses on the deposition of pure (a-C:H) and tungsten-doped hydrogen-containing amorphous carbon coatings (a-C:H:W) and the detailed characterization of their chemical, cytological, mechanical and adhesion behavior. The coatings are fabricated by physical vapor deposition (PVD) and display typical DLC morphology and composition, as verified by focused ion beam scanning electron microscopy and Raman spectroscopy. Their roughness is higher than that of the plain substrates. Initial screening with contact angle and surface tension as well as in vitro testing by indirect and direct application indicate favorable cytocompatibility. The DLC coatings feature excellent mechanical properties with a substantial enhancement of indentation hardness and elastic modulus ratios. The adhesion of the coatings as determined in modified scratch tests can be considered as sufficient for the use in TKAs.

Amorphous Carbon Coatings for Total Knee Replacements-Part II: Tribological Behavior.

Diamond-like carbon coatings may decrease implant wear, therefore, they are helping to reduce aseptic loosening and increase service life of total knee arthroplasties (TKAs). This two-part study addresses the development of such coatings for ultrahigh molecular weight polyethylene (UHMWPE) tibial inlays as well as cobalt-chromium-molybdenum (CoCr) and titanium (Ti64) alloy femoral components. While the deposition of a pure (a-C:H) and tungsten-doped hydrogen-containing amorphous carbon coating (a-C:H:W) as well as the detailed characterization of mechanical and adhesion properties were the subject of Part I, the tribological behavior is studied in Part II. Pin-on-disk tests are performed under artificial synovial fluid lubrication. Numerical elastohydrodynamic lubrication modeling is used to show the representability of contact conditions for TKAs and to assess the influence of coatings on lubrication conditions. The wear behavior is characterized by means of light and laser scanning microscopy, Raman spectroscopy, scanning electron microscopy and particle analyses. Although the coating leads to an increase in friction due to the considerably higher roughness, especially the UHMWPE wear is significantly reduced up to a factor of 49% (CoCr) and 77% (Ti64). Thereby, the coating shows continuous wear and no sudden failure or spallation of larger wear particles. This demonstrated the great potential of amorphous carbon coatings for knee replacements.

Rheological behavior of an artificial synovial fluid - influence of temperature, shear rate and pressure.

Despite the excellent clinical performance of joint replacements, wear-induced aseptic loosening is a main cause of premature implant failure. Tribological testing is usually carried out using bovine serum as an artificial synovial fluid. In order to gain new insights into the suitability to simulate human synovial fluid and provide recommendations for the conditions of tribological testing, accurate rheological measurements on the influence of temperature, shear rate and pressure on density and viscosity were performed. Thus, a temperature dependence of density and viscosity could be verified, whereas both values decreased with higher temperatures. The temperature dependency of viscosity could be approximated by an Arrhenius model. Moreover, shear-thinning characteristics could be demonstrated and fitted to a Cross model, which agreed well with investigations on human synovial fluid reported in literature. Furthermore, an anomaly of pressure dependence of viscosity was found and correlated with the behavior of water as a main constituent. At room temperature, the viscosity initially decreased to a minimum and then increased again as a function of pressure. This was no longer distinct at human body temperatures. Consequently, the present study confirms the suitability of bovine serum as a substitute synovial fluid and emphasizes the importance of realistic testing conditions in order to ensure transferability and comparability.