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Jove Graham

Publications and source records attributed to Jove Graham.

3 recordsLinked to original sources

Wear and surface cracking in early retrieved highly cross-linked polyethylene acetabular liners.

BACKGROUND: A higher degree of cross-linking has been shown to improve the tribological properties of ultra-high molecular weight polyethylene in laboratory studies; however, its effect on in vivo behavior has not been well established. We investigated in vivo wear mechanisms in retrieved highly cross-linked polyethylene acetabular liners in order to determine if early in vivo wear behavior is accurately predicted by hip-simulator studies. METHODS: A total of twenty-four liners (twenty-one explanted and one unimplanted highly cross-linked liners and two explanted ethylene-oxide-sterilized non-cross-linked liners) were examined for this study. The average age of the patients was 59.9 years, and the average time in vivo was 10.1 months. Articular surface damage on the front and back sides of the liners was assessed with an optical scoring system. Surface quadrants were assigned a grade from 0 to 3 according to the observed wear mechanisms and the percentage of surface affected. The micromechanisms of liner damage were evaluated with use of scanning electron microscopy. RESULTS: The average front and back-side explant damage scores were 11 (range, 2 to 26.5) and 6.7 (range, 3.7 to 13.3), respectively. There was consistent evidence of early surface deformation and cracking. All explants exhibited some form of surface change, including surface cracking, abrasion, pitting, or scratching. The original machining marks on the liner surface were observed to be either unaltered, drastically distorted, or absent. CONCLUSIONS: Highly cross-linked ultra-high molecular weight polyethylene acetabular liners that were retrieved at an average of ten months after implantation exhibited signs of surface damage that had not been predicted by in vitro hip-simulator studies. These devices had not failed clinically as a result of wear. The discrepancy between in vitro and in vivo wear surfaces may be due to variability in terms of in vivo lubrication and cyclic loading or may represent early surface damage mechanisms that are not well demonstrated by long-term simulator studies.

Acetabulum↗

Effect of bone porosity on the mechanical integrity of the bone-cement interface.

BACKGROUND: Osteopenia is one factor that may influence the decision about the type of implant fixation to use in total hip arthroplasty. However, clinical studies generally do not associate the outcome of an arthroplasty with the degree of osteopenia. The mechanical integrity of the cement fixation of an implant may be affected by the relative degree of osteopenia, which could account for some of the variable long-term results after total hip arthroplasty performed with cement. The purpose of this study was to determine the effects of bone porosity, trabecular orientation, cement pressure, and cement penetration depth on fracture toughness at the bone-cement interface. METHODS: Trabecular bone from the proximal part of bovine femora was used with a single brand of commercial acrylic bone cement to form compact-tension interface specimens representing a range of bone porosities, orientations, and cement pressures within a clinically achievable range. All specimens were loaded to failure with use of a servohydraulic testing machine, and fracture toughness at the interface was calculated. After testing, images of a representative sample of specimens were made with use of computed tomography to measure the penetration depth of the cement into the bone. RESULTS: Significant correlations were found between fracture toughness and bone porosity, trabecular orientation, and cement pressure, with bone porosity having the strongest effect (p < 0.000015). Examination of the computed tomographic images also showed a significant correlation between fracture toughness and maximum cement penetration depth (p < 0.033), as well as significant partial correlations between maximum and mean penetration depth and bone porosity (p < 0.0037 and p < 0.0028). CONCLUSION: The fracture resistance of the bone-cement interface is greatly improved when the ability of the cement to flow into the intertrabecular spaces is enhanced.

Animals↗

Retrieved glenoid components: a classification system for surface damage analysis.

There have been many reports describing modes of damage in retrieved total hip and total knee arthroplasty components. The most common mechanism in total hip arthroplasties has been shown to be surface wear. Fatigue failure shown as pitting and delamination are observed more often in total knee components. There has been no previous analysis of retrieved polyethylene glenoid components. This study evaluated the wear mechanisms contributing to failure of total shoulder glenoid components. Polyethylene glenoid components from 10 consecutive total shoulder arthroplasties have been retrieved and analyzed. Wear mechanisms were analyzed under low-power magnification, and a classification system was designed for total shoulder arthroplasties. This classification system is an adaptation of previous models of hip and knee surface damage. The severity of each damage mode was graded in 4 separate quadrants. The most prevalent damage modes were abrasion, pitting, and delamination. These data show a combination of abrasive wear and fatigue in retrieved total shoulder specimens. Surface wear and subsurface fatigue failure mechanisms both contribute to glenoid implant failure.

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