Biomedical subjects

A Unsworth

Publications and source records attributed to A Unsworth.

At least 55 records · Page 3Linked to original sources

PubMed1998

Differences in the rates of penetration determined from radiographic and shadowgraphic measurements of acetabular sockets.

A number of previous studies have observed a marked difference in the penetration depths recorded between direct and radiographic measurement, although no assessment of how these discrepancies affect the rates of penetration has been undertaken. In this report, the penetration depth of 95 sockets was determined from both prerevision radiographs and casts of the retrieved sockets using the uniradiographic and shadowgraphic techniques, respectively. It was observed that the mean discrepancy between the penetration rates derived from the two measurement methods was 0.046 (SE 0.017) mm yr(-1), which was significantly different from zero at P = .007. It was concluded that the penetration rates derived from this method of radiographic assessment seriously underestimated the true value as measured by a direct method by approximately 20%. As a consequence, the discrepancy in penetration rates between those sockets that are loose at revision surgery (direct measurement) and the general population of acetabular components (radiographic measurement) may not be as large as previously thought.

Acetabulum↗

PubMed1998

Wear in retrieved acetabular components: effect of femoral head radius and patient parameters.

Forty-seven explanted Porous Coated Anatomic (PCA, Howmedica, Rutherford, NJ) cementless acetabular components were acquired at revision surgery. All the components articulated against CoCrMo femoral heads of 32-mm diameter. The penetration depth and angle were measured using the shadowgraph technique. The wear volume was then calculated using Kabo's formula. Using weighted linear regression analysis, the mean penetration rate and mean volumetric wear rate were calculated to be 0.23 (SE, 0.03) mm3/y and 96 (SE, 13) mm3/y, respectively. The creep component was not found to be significantly different from zero. The clinical wear factor, k(clinical), for this cohort was also calculated using linear regression analysis but with the assumption that creep was zero. The value found, k(clinical) = 1.93 (SE, 0.29) x 10(-6) mm3/N-m, was similar to those in previous studies involving cemented joints with a 22-mm femoral head diameter. The similar k(clinical) values of these substantially different joint types suggest that the high volumetric wear rate for the PCA joint can be attributed entirely to its larger head size and the younger, more active, patient profile. Fixation technique and metal backing seem not to influence the rate of wear.

Acetabulum↗

PubMed1998

Discrepancy between penetration depths derived from radiographic and direct measurement of acetabular components.

The most common technique for assessing penetration due to wear in acetabular components is with the aid of the most recent serial radiograph. This approach, which is often termed the uni-radiographic method, has been shown to underestimate the more reliable value of the penetration depth deduced from direct measurement of explanted sockets. In this article the causes of the discrepancies between the two data sets are explored. Ninety-six sockets were available from revision surgery for which both the penetration depth and angle could be measured using the shadowgraphic technique in both the coronal and wear planes. Further, the penetration depth for each of the sockets was also assessed from pre-revision X-rays. A significant discrepancy was observed between the penetration depths measured in the wear plane of the replica delta Pw and that measured from the radiograph, delta PX-ray. The discrepancy was greatest for loose sockets as opposed to those that were still fixed at revision surgery. Using the corresponding data from the shadowgraph measurements, it was possible to deduce that the errors have arisen from the radiographic measurement of wear in the coronal plane and the formula used in calculating delta PX-ray. If these errors (which cannot be calculated from the X-ray data alone) were taken into consideration, then the systematic bias between radiographic and shadowgraphic measurement was greatly reduced. The largest portion of the discrepancy was accounted for by wear occurring out of the plane of the radiograph, and this, in general, coincides with the coronal plane. Overall, these results indicate that the accurate measurement of wear from serial radiographs is not possible and that improved performance in terms of accuracy can only be achieved when a three-dimensional system is used. An alternative method for deducing the radiographic penetration depth is proposed which, theoretically, negates the error arising from the inaccuracy of the formula.

Acetabulum↗

PubMed1998

The association between rates of wear in retrieved acetabular components and the radius of the femoral head.

Current evidence suggests that loosening of the acetabular socket is related to the volume of ultra-high molecular weight polyethylene wear debris generated at the articulating surfaces, through a process of bone resorption. Therefore it is important that the rate of volumetric wear is minimized in an attempt to extend the useful life of the procedure. Laboratory evidence indicates that a reduction in sliding distance would be beneficial in achieving this target and may be attained by a reduction in femoral head radius. To investigate the relationship between femoral head size and the rates of both volumetric wear and penetration, 200 acetabular components were retrieved at the time of revision surgery. The joints had femoral heads ranging in size from 11.1 to 19.8 mm radius. For those sockets that were loose at revision surgery, a significant correlation was observed, between the rate of volumetric wear and the radius of the femoral head. For this cohort an increase in radius of 1 mm resulted in an increased rate of volumetric wear of 5.1 (SE 1.4) mm3/yr. However, the explained variance in the regression was low and exemplifies the multifactorial nature of the wear process. In particular, it is anticipated that the activity of the patient will have a significant effect on the rate at which the debris is produced. No significant correlation was observed between the rate of linear wear and femoral head radius. These results would indicate a benefit in using head sizes of a smaller radius, which generate debris at a reduced rate, and therefore require more time to accumulate large volumes of wear products.

Aged↗

PubMed1998

The frictional behaviour of explanted PCA hip prostheses.

The frictional characteristic of 22 explanted and two unused PCA total hip arthoplasties were assessed using the Durham hip simulator. The friction of the explanted joints was not found to be significantly different from that of the unused joints. In contrast, explanted Charnley joints often exhibit increased frictional characteristics. This discrepancy is accounted for by the lack of cement ingression in the PCA design.

Adult↗

PubMed1998

Observations on the direction of wear in Charnley sockets retrieved at revision.

The direction of wear in the acetabular socket has implications for the amount of debris that is generated during movement, for the magnitude of eccentric loading and for the incidence of impingement of the neck. We observed the direction of penetration with respect to a global co-ordinate system in 84 acetabular components retrieved at reoperation. The mean direction of wear relative to the open face of the sockets was found to be 37 degrees with a range from 0 degrees to 87 degrees. For those values determined using the inclination of the socket on the prerevision radiograph, the mean direction of penetration in the coronal plane had a lateral, rather than a medial, component. The mean angle was 84 degrees (SD 17 degrees) with respect to the horizontal. The angle of penetration was found to correlate significantly with the depth, in that the lateral component became larger as the wear progressed. There was also a significant correlation between the rate of penetration and the direction of wear. Despite the theoretical advantage of penetration in the superolateral direction, i.e., along the margin of the socket, in reducing the probability of impingement of the neck, no significant correlation was seen between the angle of penetration and the period of use in vivo. This may suggest that impingement of the femoral neck on the rim of the socket may not be the dominant factor in loosening of the socket but can still be important in a few cases.

Acetabulum↗

PubMed1997

Friction in hip prostheses.

Although the reduction of frictional torques was the driving force behind the design of the Charnley prosthesis, later concerns about wear and subsequent loosening of this and other hip replacements have dominated debate within the bioengineering community. To stimulate discussion on the role of friction in loosening, a review of the frictional characteristics of different prostheses was undertaken. The use of simple laboratory screening-type machines in the frictional assessment of different material combinations is discussed together with experiments performed on single axis simulators using both conventional and experimental prostheses. In particular, recent developments in the use of soft layer components are highlighted. Further, the possible link between excessively high frictional torques and loosening is discussed in the light of current results obtained from explanted prostheses.

Alloys↗

PubMed1997

The effect of surface topography of retrieved femoral heads on the wear of UHMWPE sockets.

The study was undertaken to investigate the association, if any, between the surface roughness of 35 explanted femoral heads and the clinical wear factors of the corresponding polyethylene sockets. The wear of the socket was measured using a shadowgraph technique. The surface topography was investigated using a Rodenstock RM 600 non-contacting profilometer, and six parameters were used to characterise the roughness. Further, qualitative inspections of the femoral surface were undertaken using both a Joel JSM-IC-848 scanning electron microscope and a Zeiss Axiotech microscope with a differential interference contrast facility. Two parameters were found to correlate with the clinical wear factor, namely the skewness of the amplitude distribution function, Sk, and the arithmetic mean roughness, Ra. Simple parameters describing the peak heights of the asperities were found not to have a significant association with the clinical wear factor. The exponent in the power relationship between the arithmetic mean roughness and kclinical was found to be equal to 0.5 (SE: 0.2). This value is significantly smaller than that found in laboratory experiments and may be due to the non-uniform nature of the roughening of the femoral head, three-body wear and the effect of other clinical factors on the wear process. Further, extremely strong correlations were detected between the differing roughness parameters, which would suggest that any attempt to deduce which one is the most important in affecting the wear of the polymeric counterface is fraught with difficulty. However, further investigation of those parameters, such as the reduced peak height or the material filled profile peak area, which may better describe the effect of the counterface on the wear of the UHMWPE surface would appear to be prudent.

Hip Prosthesis↗

PubMed1997

The friction of explanted hip prostheses.

Charnley prostheses, retrieved at revision surgery, were studied to assess the effects of friction on the total hip replacement procedure. Frictional resistance was measured using the Durham hip function simulator under both dry and lubricated conditions. The friction factor values (f) for the explanted prostheses were found to have a non-Gaussian distribution with medians of 0.13 [inter-quartile range (IQR) 0.10-0.16] and 0.06 (IQR 0.005-0.08) for dry and lubricated (n = 0.01 Pa s) regimes, respectively. New Charnley prostheses had values of f equal to 0.11 +/- 0.025 and 0.04 +/- 0.01 under the same conditions, and showed no large deviation from a Gaussian distribution. There was found to be a statistically significant difference in the medians of the friction factors for new and retrieved prostheses in the lubricated regime. Ingression of cement into the worn region of the cup was found to increase the friction factor significantly under dry conditions. There was no evidence of an increase in the friction factor or torque for those joints that had a loose socket with respect to those that were fixed at revision. A decrease in the frictional torque against number of cycles undergone by the joint in vivo may indicate that a fatigue-type process may have a role in the loosening of the socket. However, this relationship was found not to be significant for friction measured under lubricated conditions and it seems unlikely that the frictional torque generated in this type of prosthesis will contribute significantly to the long-term loosening of the socket.

Adult↗

PubMed1997

Further studies into proximal interphalangeal joint dimensions for the design of a surface replacement prosthesis: medullary cavities and transverse plane shapes.

The proximal and middle phalanges from 83 proximal interphalangeal joints (PIPJs) were set in clear plastic and sectioned in the transverse plane leaving the heads whole. The sections were cleaned, shadowgraphed and measured. The medullary canals were marked on sagittal and frontal plane shadowgraphs of the intact bones and analysed. The information was then used in the design of a surface replacement prosthesis for the PIPJs. The main dorsal surface of the proximal phalanx (PP) was found to be angled to the longitudinal baseline of the bone by a mean of 5.19 degrees. This angle increased just proximal to the phalangeal head to a mean of 11.84 degrees. The mean ratio between these angles was 2.71. The phalangeal shaft bone was thicker laterally than dorsally and palmarly, and thicker dorsally than palmarly for the proximal and middle phalanges throughout the length of the bone. The shape and size of the transverse cross-section of the medullary canal changed throughout the length of the shaft. The centreline of the PP medullary canal coincided with the midline of the bone in the frontal plane and was approximately a straight line along the length of the canal. In the sagittal plane the centreline was slightly palmar to the midline and the angle between it and the longitudinal baseline of the bone changed along the length of the canal. In the region of the shaft just proximal to the PP head (where the stem of a surface replacement prosthesis would fit) the mean angle was 10.63 degrees. The centreline was offset dorsally from the centre of rotation of the PIPJ by a mean of 0.83 mm, 0.83 mm, 0.80 mm and 0.57 mm for the index, middle, ring and little fingers respectively, with an overall mean of 0.76 mm. The mean PP head heights (transverse plane) were 9.17 mm, 9.33 mm, 8.73 mm and 7.40 mm and the mean PP widths (transverse plane) were 12.86 mm, 13.25 mm, 12.75 mm and 10.54 mm for the index, middle, ring and little fingers respectively. The mean angle between the lateral sides of the condyles to the transverse baseline was 78.35 degrees and the mean distance from the centreline of the PP head (transverse plane) to the bases of the two condyles was 4.69 mm. The mean maximum depth of the PP head intercondylar sulcus in the frontal plane was 0.72 mm and in the transverse plane, the mean maximum depth of the intercondylar sulcus on the anterior face was 0.82 mm.

Aged↗

PubMed1997

Development of a six station knee wear simulator and preliminary wear results.

In order to assess the wear performance of different designs of total knee replacements (TKR), a six station multi-axis knee simulator has been designed, built and commissioned. The most important features of a knee simulator are representative angles of flexion-extension synchronized with a dynamically applied load, and a combination of rolling and sliding motion. The simulator typically applies flexion-extension of 0-65, anterior-posterior translation of up to 15 mm, a dynamic load of up to 5.0 kN, and operates at 1.0 Hz. The loads and motions are applied using computer controlled servohydraulic actuators and hence their profiles are easily modified. A preliminary wear test has been conducted using a Kinemax (Howmedica, United Kingdom) TKR. The test was conducted in 30 per cent bovine serum which was changed every 150,000 cycles, at which time the bearing surfaces were examined and the UHMWPE tibial component was weighed. Over eight million cycles, a tibial wear rate of 2.62 mg/10(6) cycles was measured. The mild wear observed was characterized by burnishing and slight scratching in the anterior posterior direction. These observations are broadly in line with both in vitro and ex vivo studies reported in the literature for this type of prosthesis. Delamination wear sometimes observed in vivo was not seen.

Animals↗

PubMed1996

The wear of cross-linked polyethylene against itself.

Cross-linked polyethylene (XLPE) may have an application as a material for an all-plastic surface replacement finger joint. It is inexpensive, biocompatible and can be injection-moulded into the complex shapes that are found on the ends of the finger bones. Further, the cross-linking of polyethylene has significantly improved its mechanical properties. Therefore, the opportunity exists for an all-XLPE joint, and so the wear characteristics of XLPE sliding against itself have been investigated. Wear tests were carried out on both reciprocating pin-on-plate machines and a finger function simulator. The reciprocating pin-on-plate machines had pins loaded at 10 N and 40 N. All pin-on-plate tests show wear factors from the plates very much greater than those of the pins. After 349 km of sliding, a mean wear factor of 0.46 x 10(-6) mm3/N m was found for the plates compared with 0.021 x 10(-6) mm3/N m for the pins. A fatigue mechanism may be causing this phenomenon of greater plate wear. Tests using the finger function simulator give an average wear rate of 0.22 x 10(-6) mm3/N m after 368 km. This sliding distance is equivalent to 12.5 years of use in vivo. The wear factors found were comparable with those of ultra-high molecular weight polyethylene (UHMWPE) against a metallic counterface and, therefore, as the loads across the finger joint are much less than those across the knee or the hip, it is probable that an all-XLPE finger joint will be viable from a wear point of view.

Biocompatible Materials↗

PubMed1996

Proximal interphalangeal joint dimensions for the design of a surface replacement prosthesis.

The bones from 83 proximal interphalangeal joints (PIPJs) were dissected in order to determine the shape and size of the articular surfaces. The bones were modelled in acrylic dental bone cement and the original bones and replicas were then sectioned and shadowgraphed. Dimensions were taken from these shadowgraphs to be used in the design of a surface replacement prosthesis for the PIPJ. It was found that the bi-condylar heads of the proximal and middle phalanges were circular in the sagittal plane as was the base of the middle phalanx. However, the radius of curvature of the middle phalangeal base was greater than that of the proximal phalangeal head indicating that the PIPJ is not a conforming joint. The alignment of the radial and ulnar condyles of the proximal phalangeal bones was investigated and it was found that the index and middle finger bones tended to have a more prominent ulnar condyle while the ring and little finger bones tended to have a more prominent radial condyle. This was due to a slight difference in diameters of the two condyles. The proximal phalangeal bone lengths L ranged from 29-52 mm, maximum head widths W from 8.5-15.5 mm and maximum diameters D of the best-fit circles to the sagittal profile of the bone head from 6-11 mm. The middle phalangeal bone lengths ranged from 16-35 mm, maximum head widths from 8.5-12 mm and maximum diameters from 5-7.5 mm. The relationships and ratios between these dimensions for the proximal and middle phalanges have been calculated.

Aged↗

PubMed1996

Wear in retrieved Charnley acetabular sockets.

One hundred and twenty-nine Charnley acetabular components were acquired at the time of revision surgery and a tribological investigation undertaken. The relative occurrence of pitting in the unworn and worn regions of the sockets suggest that most of the cement ingress occurs during the early part of the service life. The penetration depth of the explanted sockets was determined using the shadowgraph technique. Observation of the profiles in the wear planes suggest that, in general, the creep component was not a significant proportion of the overall change in the inner bore of the socket. Using weighted ordinary least squares regression, in which the intercept was not assumed to be zero, mean penetration and wear volume rates of 0.02 (SE = 0.02) mm/year and 55 (SE = 5) mm3/year, respectively, were recorded and are in agreement with other retrieval studies. In neither case was the intercept found to be significantly different from zero. A mean clinical wear factor, Kclinical, equal to 2.1 (SE = 0.2) x 10(-6) mm3/N m was calculated which is considerably larger than that found in laboratory experiments which purport to reflect in vivo conditions. In this analysis, a significant positive intercept was observed [96 (SE = 36) mm3] and may be evidence of the small initial penetration due to creep reported in simulator experiments. A strong positive association between kclinical and the arithmetical mean roughness, Ra, of the femoral head was also demonstrated although the rate of change was not as great as that cited for laboratory experiments.

Acetabulum↗

PubMed1996

A comparison of the wear of cross-linked polyethylene against itself with the wear of ultra-high molecular weight polyethylene against itself.

Wear tests were carried out on reciprocating pin-on-plate machines which had pins loaded at 10 N and 40 N. The materials tested were irradiated cross-linked polyethylene sliding against itself, irradiated ultra-high molecular weight polyethylene sliding against itself and non-irradiated ultra-high molecular weight polyethylene sliding against itself. After 153.5 km of sliding, the non-irradiated ultra-high molecular weight polyethylene plates and pins showed mean wear factors under 10 N loads, or a nominal contact stress of 0.51 MPa, of 84.0 x 10(-6) mm3/N m for the plates and 81.3 x 10(-6) mm3/N m for the pins. Under 40 N loads, or a nominal contact stress of 2.04 MPa, the non-irradiated ultra-high molecular weight polyethylene pins sheared at 22.3 km. At the last measurement point prior to this failure, 19.1 km, wear factors of 158 x 10(-6) mm3/N m for the plates and 85.0 x 10(-6) mm3/N m for the pins had been measured. After 152.8 km. the irradiated ultra-high molecular weight polyethylene plates and pins showed mean wear factors under 10 N loads of 59.8 x 10(-6) mm3/N m for the plates and 31.1 x 10(-6) mm3/N m for the pins. In contrast, after 150.2 km, a mean wear factor of 0.72 x 10(-6) mm3/N m was found for the irradiated cross-linked polyethylene plates compared with 0.053 x 10(-6) mm3/N m for the irradiated cross-linked polyethylene pins.

Biocompatible Materials↗

PubMed1995

Axisymmetric finite element analysis of hip replacements possessing an elastomeric layer: the effects of clearance and Poisson's ratio.

A finite element analysis has been performed for a hip replacement incorporating an elastomeric surface layer. The effects of assuming the elastomer as incompressible have been examined for imposed loads, by comparing the incompressible solution to that using accurately measured values for Poisson's ratio, and while deflections were found to be significantly different, the changes in maximum pressure in the contact, maximum shear stress, contact angle and angular position to maximum shear stress were all small (less than 10 per cent). Comparisons have also been made between the finite element results for ABAQUS and an asymptotic solution, and it was found to be important to use the numerical model particularly at small values of clearance.

Hip Prosthesis↗

PubMed1995

An appraisal of the paper by O'Carrol et al. (1990).

The paper by O'Carrol et al. (1), which addresses the problem of an elastomeric disc indented by a spherical punch, has been evaluated. The sources of disagreement between linear elastic numerical predictions and experimental measurements noted in this paper have been critically examined in the light of finite element forecasts obtained with a package which incorporates finite elasticity effects and incompressibility.

Biomechanical Phenomena↗

PubMed1995

Measurement of wear in retrieved acetabular sockets.

Twenty-eight standard Charnley sockets were retrieved at revision surgery. The penetration angle with respect to the cup coordinate system, beta, and penetration depth, d, of the sockets were measured using both the traditional shadowgraph technique and by analysing data obtained from a coordinate measuring machine (CMM). In addition, d was deduced radiographically from pre-revision X-rays. Limits of agreement between the three methods of measuring d were of the order of +/- 0.5 mm. Using the data obtained from the CMM it was possible to deduce the wear volume Vmeas directly. It was found that, in general, values of the wear volume calculated from d and beta using equations cited elsewhere (1, 2) were both imprecise and inaccurate. The direct measurement of the wear volume using the CMM depends on the location of reference points external to the wear surface. If such surfaces were damaged, then it was concluded that the shadowgraph technique provided the most suitable method for measuring the dimensional changes in the retrieved socket, due to its relative ease of use.

Bias↗