UHMWPE Biomaterials Handbook 2nd ed
A Primer on UHMWPE
From Ethylene Gas to UHMWPE Component: The Process of Producing Orthopedic Implants
Packaging and Sterilization of UHMWPE
The Origins of UHMWPE in Total Hip Arthroplasty
Clinical Performance of UHMWPE in Hip Replacements
Contemporary Total Hip Arthroplasty: Hard-on-Hard Bearings and Highly Crosslinked UHMWPE
Origins and Adaptations of UHMWPE for Knee Replacements
Clinical Performance of UHMWPE in Knee Replacements
Clinical Performance of UHMWPE in Shoulder Replacements
Clinical Performance of UHMWPE in Elbow Replacements
Applications of UHMWPE in Total Ankle Replacements
Clinical Performance of UHMWPE in the Spine
Highly Crosslinked and Melted UHMWPE
Highly Crosslinked and Annealed UHMWPE
Highly Crosslinked UHMWPE Doped with Vitamin E
Vitamin E-Blended UHMWPE Biomaterials
Composite UHMWPE Biomaterials and Fibers
UHMWPE/ Hyaluronan Microcomposite Biomaterials
High Pressure Crystallized UHMWPEs
Compendium of Highly Crosslinked UHMWPEs
Mechanisms of Crosslinking, Oxidative Degradation and Stabilisation of UHMWPE
In Vivo Oxidation of UHMWPE
Pathophysiologic Reactions to UHMWPE Wear Particles
Characterization of Physical, Chemical, and Mechanical Properties of UHMWPE
Tribological Assessment of UHMWPE in the Hip
Tribological Assessment of UHMWPE in the Knee
Characterisation of UHMWPE Wear Particles
Clinical Surveillance of UHMWPE Using Radiographic Methods
ESR Insights into Macro Radicals in UHMWPE
Fatigue and Fracture of UHMWPE
Development and Application of the Notched Tensile Test to UHMWPE
Development and Application of the Small Punch Test to UHMWPE
Nano- and Micro-Indentation Testing of UHMWPE
MicroCT Analysis of Wear and Damage in UHMWPE
Computer Modeling and Simulation of UHMWPE
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Copyright PageDedicationForewordContributors
Select Chapter 1 – A Primer on UHMWPE
Book chapterAbstract only
Chapter 1 – A Primer on UHMWPE
Steven M. Kurtz
Select Chapter 2 – From Ethylene Gas to UHMWPE Component: The Process of Producing Orthopedic Implants
Book chapterAbstract only
Chapter 2 – From Ethylene Gas to UHMWPE Component: The Process of Producing Orthopedic Implants
Steven M. Kurtz
Select Chapter 3 – Packaging and Sterilization of UHMWPE
Book chapterAbstract only
Chapter 3 – Packaging and Sterilization of UHMWPE
Steven M. Kurtz
Select Chapter 4 – The Origins of UHMWPE in Total Hip Arthroplasty
Book chapterAbstract only
Chapter 4 – The Origins of UHMWPE in Total Hip Arthroplasty
Steven M. Kurtz
Select Chapter 5 – The Clinical Performance of UHMWPE in Hip Replacements
Book chapterAbstract only
Chapter 5 – The Clinical Performance of UHMWPE in Hip Replacements
Steven M. Kurtz
Select Chapter 6 – Contemporary Total Hip Arthroplasty: Hard-on-Hard Bearings and Highly Crosslinked UHMWPE
Book chapterAbstract only
Chapter 6 – Contemporary Total Hip Arthroplasty: Hard-on-Hard Bearings and Highly Crosslinked UHMWPE
Steven M. Kurtz and Kevin Ong
Select Chapter 7 – The Origins and Adaptations of UHMWPE for Knee Replacements
Book chapterAbstract only
Chapter 7 – The Origins and Adaptations of UHMWPE for Knee Replacements
Steven M. Kurtz
Select Chapter 8 – The Clinical Performance of UHMWPE in Knee Replacements
Book chapterAbstract only
Chapter 8 – The Clinical Performance of UHMWPE in Knee Replacements
Steven M. Kurtz
Select Chapter 9 – The Clinical Performance of UHMWPE in Shoulder Replacements
Book chapterAbstract only
Chapter 9 – The Clinical Performance of UHMWPE in Shoulder Replacements
Stefan M. Gabriel
Select Chapter 10 – The Clinical Performance of UHMWPE in Elbow Replacements
Book chapterAbstract only
Chapter 10 – The Clinical Performance of UHMWPE in Elbow Replacements
Judd S. Day
Select Chapter 11 – Applications of UHMWPE in Total Ankle Replacements
Book chapterAbstract only
Chapter 11 – Applications of UHMWPE in Total Ankle Replacements
Allyson Ianuzzi and Chimba Mkandawire
Select Chapter 12 – The Clinical Performance of UHMWPE in the Spine
Book chapterAbstract only
Chapter 12 – The Clinical Performance of UHMWPE in the Spine
Steven M. Kurtz, Marta L. Villarraga and Allyson Ianuzzi
Select Chapter 13 – Highly Crosslinked and Melted UHMWPE
Book chapterAbstract only
Chapter 13 – Highly Crosslinked and Melted UHMWPE
Orhun K. Muratoglu
Select Chapter 14 – Highly Crosslinked and Annealed UHMWPE
Book chapterAbstract only
Chapter 14 – Highly Crosslinked and Annealed UHMWPE
John H. Dumbleton, Aiguo Wang, … Michael T. Manley
Select Chapter 15 – Highly Crosslinked UHMWPE Doped with Vitamin E
Book chapterAbstract only
Chapter 15 – Highly Crosslinked UHMWPE Doped with Vitamin E
Ebru Oral and Orhun K. Muratoglu
Select Chapter 16 – Vitamin-E-Blended UHMWPE Biomaterials
Book chapterAbstract only
Chapter 16 – Vitamin-E-Blended UHMWPE Biomaterials
Steven Kurtz, Pierangiola Bracco and Luigi Costa
Select Chapter 17 – Composite UHMWPE Biomaterials and Fibers
Book chapterAbstract only
Chapter 17 – Composite UHMWPE Biomaterials and Fibers
Steven M. Kurtz
Select Chapter 18 – UHMWPE/Hyaluronan Microcomposite Biomaterials
Book chapterAbstract only
Chapter 18 – UHMWPE/Hyaluronan Microcomposite Biomaterials
Susan P. James, Rachael (Kurkowski) Oldinski, … Herb Schwartz
Select Chapter 19 – High Pressure Crystallized UHMWPEs
Book chapterAbstract only
Chapter 19 – High Pressure Crystallized UHMWPEs
Anuj Bellare and Steven M. Kurtz
Select Chapter 20 – Compendium of Highly Crosslinked UHMWPEs
Book chapterAbstract only
Chapter 20 – Compendium of Highly Crosslinked UHMWPEs
Steven M. Kurtz
Select Chapter 21 – Mechanisms of Crosslinking, Oxidative Degradation and Stabilization of UHMWPE
Book chapterAbstract only
Chapter 21 – Mechanisms of Crosslinking, Oxidative Degradation and Stabilization of UHMWPE
Luigi Costa and Pierangiola Bracco
Select Chapter 22 – In Vivo Oxidation of UHMWPE
Book chapterAbstract only
Chapter 22 – In Vivo Oxidation of UHMWPE
Steven M. Kurtz
Select Chapter 23 – Pathophysiologic Reactions to UHMWPE Wear Particles
Book chapterAbstract only
Chapter 23 – Pathophysiologic Reactions to UHMWPE Wear Particles
Marla J. Steinbeck, Ryan M. Baxter and Theresa A. Freeman
Select Chapter 24 – Characterization of Physical, Chemical, and Mechanical Properties of UHMWPE
Book chapterAbstract only
Chapter 24 – Characterization of Physical, Chemical, and Mechanical Properties of UHMWPE
Stephen Spiegelberg
Select Chapter 25 – Tribological Assessment of UHMWPE in the Hip
Book chapterAbstract only
Chapter 25 – Tribological Assessment of UHMWPE in the Hip
Aaron Essner and Aiguo Wang
Select Chapter 26 – Tribological Assessment of UHMWPE in the Knee
Book chapterAbstract only
Chapter 26 – Tribological Assessment of UHMWPE in the Knee
Hani Haider
Select Chapter 27 – Characterization of UHMWPE Wear Particles
Book chapterAbstract only
Chapter 27 – Characterization of UHMWPE Wear Particles
Joanne L.Tipper, Laura Richards, … John Fisher
Select Chapter 28 – Clinical Surveillance of UHMWPE Using Radiographic Methods
Book chapterAbstract only
Chapter 28 – Clinical Surveillance of UHMWPE Using Radiographic Methods
Charles R. Bragdon
Select Chapter 29 – ESR Insights into Macroradicals in UHMWPE
Book chapterAbstract only
Chapter 29 – ESR Insights into Macroradicals in UHMWPE
M. Shah Jahan
Select Chapter 30 – Fatigue and Fracture of UHMWPE
Book chapterAbstract only
Chapter 30 – Fatigue and Fracture of UHMWPE
Francisco J. Medel and Jevan Furmanski
Select Chapter 31 – Development and Application of the Notched Tensile Test to UHMWPE
Book chapterAbstract only
Chapter 31 – Development and Application of the Notched Tensile Test to UHMWPE
Michael C. Sobieraj and Clare M. Rimnac
Select Chapter 32 – Development and Application of the Small Punch Test to UHMWPE
Book chapterAbstract only
Chapter 32 – Development and Application of the Small Punch Test to UHMWPE
Avram A. Edidin
Select Chapter 33 – Nano- and Microindentation Testing of UHMWPE
Book chapterAbstract only
Chapter 33 – Nano- and Microindentation Testing of UHMWPE
Jeremy L. Gilbert and James D. Wernle
Select Chapter 34 – MicroCT Analysis of Wear and Damage in UHMWPE
Book chapterAbstract only
Chapter 34 – MicroCT Analysis of Wear and Damage in UHMWPE
Dan MacDonald, Anton Bowden and Steven M. Kurtz
Select Chapter 35 – Computer Modeling and Simulation of UHMWPE
Book chapterAbstract only
Chapter 35 – Computer Modeling and Simulation of UHMWPE
Anton E. Bowden, Erin Oneida and Jorgen Bergström
Select Index
Index
A
AAOS. See American Academy of Orthopedic
Surgeons (AAOS)
Acclaim total elbow, DePuy, 144–146
Acetabular components
gamma-sterilized Hylamer, 285
wear performance in, 45–46
modular, 51
AcroFlex artificial disc, 172
Activ-C, 188
Activ-L, 184
Adamirova, L., 238
Adaptive immune response, 343
Adiabatic heating, 199
Aesculap AG & Co., 180, 184, 188
Aesculap Implant Systems, Inc., 184
Agility total ankle prosthesis, 159–161, 165
Aging (accelerated and natural), small punch
test for, 487–490
changes in mechanical behavior, 489–490
Ainsworth, R., 250
Air-permeable packaging, gamma sterilization
in, 22–23
Algorithm
automatic registration, 516
Nelder-Mead simplex minimization, 529
Nelder-Mead simplex optimization, 517
Alkoxy macroradical (RO), 314 Alkyl macroradical (R), 314
hydrogen transfer to, 311
Alkyl radical, ESR, 436
Allyl radical, ESR, 436–437
Al-Malaika, S., 239
AltrX, 292–293
development history, 292–293
properties of, 293
in vitro performance, 293
Alumina (Al2O3), for hip arthroplasty, 63
American Academy of Orthopedic Surgeons
(AAOS), 43, 295, 306
American Society for Testing and Materials
(ASTM), 29, 129, 292, 330, 356, 414
Amstutz, H.C., 60
Anderson, B.C., 254
Annealing, defined, 73
Arakawa, T., 279
ArCom, 15
ArCom XL polyethylene, 293–294
development history of, 294
properties and in vitro performance, 294
Arthritis, 120
Aspect ratio (AR), defined, 415
ASTM. See American Society for Testing and
Materials (ASTM)
ASTM 2183, 523
ASTM E691, 514
ASTM F 648-96, 208
ASTM F732 standard, 383
ASTM oxidation index
mechanical behavior and, 331
quantification of ketones, 315
ASTM-type protocol, 190
Austin Moore prosthesis, 33
Austria
vitamin E studies from, 240–242
AutoCAD 2004, 515
Autoloader, DSC with, 357
Automated meshing software, 520
Automated particle size analysis, of wear
particles, 413
Automatic registration algorithm, 516
B
Baker, D., 283
Balazs, E.A., 261, 262
Baldini, T.H., 12
Barrier packaging, gamma sterilization in,
23–25
Bartel, D.L., 93
Basell Polyolefins (Wilmington, Delaware,
USA), 8, 10, 11
Basic Principle of Spectroscopy, 436
Bassett, D.C., 277, 279, 280, 281
Bath prosthesis, 158
Beavers, E.M., 268
Behrens, W., 231
Bendich, A., 230
Berdia, S., 49
Berzen, J., 238
Bhateja, S.K., 277
Bicondylar knee replacements
cruciate sparing, 87–89
total condylar knee, 89–90
Biocompatibility
of UHMWPE /HA, 273
vitamin E, 229
toxicity. See Toxicity, vitamin E
Biological activity, of wear particles, 415–420
FBA, 415–416, 419, 420
materials, 416
methods, 416–417
hip simulator, 416
knee simulator, 416–417
SBA, 415–416, 419, 420
size distribution, 417
volumetric wear rates, 417
Biological factors, in hip simulation/simulator,
371–372
BIOLOX Delta, 64–65, 69
BIOLOX Forte, 63
Biomaterial factors, in hip simulation/
simulator, 372–374
Crossfire, 373
Hylamer, 373
PTFE, 372–373
Biomechanical factors, in hip simulation/
simulator, 369–371
Biomechanics
TAR, 154–155
TEA, 141
TKA, 98–102
TSR, 121–122
Biomet, Inc., 60, 122, 294
BioPoly™, 259
Biostability, of UHMWPE/HA, 268
Birnkraut, H.W., 8
Bohler, M., 68
Bolland’s cycle, 312, 313
Boltzmann’s superposition principle, 525
Bone cement, for hip arthroplasty, 33
Bonfield, W., 255
Bovine blood serum, for TKR wear test,
404–405
Bowden, 512
BOX prosthesis, 164–165
Bragdon, C.R., 197
British Standards Institution (BSI),
413–414
Bryan. R.S., 85, 86
BSI. See British Standards Institution
(BSI)
Buechel, F.F., 93
Buechel-Pappas, 162
C
Cadaver test, 161
Calcium stearate, 11–12
Capitellocondylar prosthesis, 143
Carbon fiber-reinforced (CFR) UHMWPE
composites, 249
Carboxylic acid (RCOOH), 315
Carder, D.R., 281
Cauchy-Green deformation tensor, 528
C-C bond, 198
Cellulose, 263
“Cement disease”, 423
CEN. See European Committee for
Standardization (CEN), the
Centerpulse Orthopedics, Inc., 295
Ceramic bearings
in TKA, 113–114
wear mechanisms in, 69–70
Ceramic fracture, 65, 70–71
Index
533534 Index
Ceramic-on-ceramic (COC) bearings, in THA,
61, 62
biomaterials for, 62
alumina, 63
oxidized zirconium, 65
silicon nitride (Si3N4), 65–66
zirconia, 64
zirconia -toughened alumina matrix
composite (ZTA), 64–65
COM bearings, 69
contemporary designs, 68–69
C-PE, 66–68
historical overview, 62
noise and squeaking from, 72
in vivo fracture risk of, 70–72
wear mechanisms, 69–70
Ceramic-on-metal (COM) bearings, 69
Ceramic-on-UHMWPE (C-PE) bearings, 66–68
TKA, 113–114
CeramTec AG (Plochingen, Germany), 63
BIOLOX Delta, 64–65, 69
BIOLOX Forte, 63
Cervical disc arthroplasty
Activ-C, 188
Discover, 188
Mobi-C, 188
PCM, 186–188
ProDisc-C, 186
Cervitech, Inc., 186
Cetyltrimethylammonium (CTA), 263
CFR. See Carbon fiber-reinforced (CFR)
UHMWPE composites
CFR composite. See Poly II
Chain folding, 278, 279
CHARIT É artificial disc, 172–178
bioengineering studies of, 175–177
clinical details of, 176
controversies in, 177
legacy of, 177–178
recent generations of, 175
SB CHARITÉ I, 173
SB CHARITÉ II, 173
SB CHARITÉ III, 173–175
in vitro biomechanical testing, 175–177
Charité Center for Musculoskeletal Surgery at
Medical University, Berlin, 173
Charnley, J., 3, 23, 31–32, 43–44, 369
acetabular components, wear rates of,
45–46
design for hip arthroplasty, with PTFE
fifth and final, 34–35
first, 33
second, interim, 33–34
knee replacements and, 84–85
pink dental acrylic cement, implant fixation
with, 33
PTFE replacement, search for, 37
wear measurement method, 49
wear rates, 47–48
Wrightington Hospital
first wear testing rig at, 36–37
implant fabrication at, 35–36
implant sterilization at, 38–39
UHMWPE at, 38
Charpy impact test, of fracture resistance,
460–461
C-H bond, 198, 222, 310, 311
Chemical characterization, 361–365
electron spin resonance (ESR), 363–364
Fourier transform infrared spectroscopy,
362–363
swell ratio testing, 364–365
trace element analysis, 361–362
Chemical crosslinking, 268
Chemokines, 343
Chen, K-C, 15
CHIRULEN, 9, 13, 330
Chmell, M.J., 284
Clarke, I.C., 370
Closed-loop servohydraulic test system, 523
CMW formulation, 33
Cobalt chrome intramedullary hinged joint, 141
Cobalt chrome molybdenum (CoCr) alloy,
57–58, 60
COC bearings. See Ceramic-on-ceramic (COC)
bearings
CoCr alloy. See Cobalt chrome molybdenum
(CoCr) alloy
Cohen, Y., 253
Collier, J.P., 208, 284
COM bearings. See Ceramic-on-metal (COM)
bearings
Compatibilization, 266
Compatibilizers, 266
Compression molding, 13–14, 265
and extrusion, 16–17
Computer-generated geometric primitives,
512–513
Connolly, G.M., 251
Constitutive model, for simulating the behavior
of UHMWPE component, 519
available modeling approaches, 520–521
Contact angle, 267
Continuous stiffness measurement (CSM),
498–499
Conversion method, 12
ArCom, 16
compression molding, 13–14
extrusion versus, 16–17
direct compression molding (DCM), 14–16
hot isostatic pressing, ArCom and, 14
ram extrusion, 14
Coonrad-Morrey total elbow arthroplasty,
143–144
Cooper, J.R., 17
Coordinate system, of knee joints, 384–386
flexion moments, 386
four-link kinematic chain, 385
hinge mechanism, 385–386
Copolymer, defined, 2
Copolymerization, 260–261
Costa, L., 237, 242
Coventry, M.B., 87
Cowper-Symonds approach, 527
C-PE bearings. See Ceramic-on-UHMWPE
(C-PE) bearings
CP-Ti plasma spray, 161
CR. See Cruciate retaining (CR)
Cracchiolo, A., 85
Crack tip opening displacement (CTOD), 463
Craven, H., 35, 38, 48
first wear testing rig by, at Wrightington
Hospital, 36–37
UHMWPE arrival, at Wrightington
Hospital, 38
Creep analysis, 366–367
Crossfire, 207, 294–295
clinical results of, 295
clinical studies, 209–210
development history, 294
hip simulator data and, 209
in OBM, 373
omnifit series II study, 211
packaging for, 295
peer-reviewed studies involving, 296
process, 208
properties, 208–209
and in vitro performance, 294–295
retrievals, 210–212
transmission electron micrographs of, 208
Crosslinked materials, small punch test,
490–492
Crosslinking, radiation, 198
chemical, 268
fatigue resistance and, 200
high-pressure crystallization and, 286
of UHMWPE/HA, 264–265
vitamin E and, 245
Crosslinking of polymer
defined, 310
and DSI testing, 505
mechanisms of, 310–312
H-crosslinking, 312
macroradical formation during
irradiation, 310–311
reaction of isolated radicals, 311
Y-crosslinking, 311
Cruciate retaining (CR), 213, 252
Crystalline lamellae, defined, 4
Crystallinity, in UHMWPE/HA, 268–269
Crystallization
extended chain. See Extended chain
crystallization
high-pressure. See High-pressure
crystallization (HPC)
CSM. See Continuous stiffness measurement
(CSM)
CTA. See Cetyltrimethylammonium (CTA)
CTOD. See Crack tip opening displacement
(CTOD)
Cupic, Z., 45–48
Cytokines, 343
and wear particles, 409
D
D’Angelo, F., 286
Dark-field microscopy, 252
Data acquisition, notched tensile test, 476
DCM. See Direct compression molding (DCM)
DCP. See Dicumyl peroxide (DCP)
Debris cyst in fibula, 162
Delipidization of tissues and simulator
lubricants, 410
Deng, M., 253
Density measurements, 361
Depth-sensing indentation (DSI) testing,
498–501
and crosslinking, 505
and material processing, 501–502
and oxidation, 503, 505
and surface preparation, 502–503
viscoelastic analysis, 498–499, 505–506
DePuy Orthopaedics, Inc., 26, 31, 32, 60, 94,
123–124. See also Acclaim Total Elbow
System, DePuyIndex 535
COM technology, 69
Devane, P.A., 49, 428–429
Dicumyl peroxide (DCP), 265
Differential scanning calorimetry (DSC), 5, 208
with autoloader, 357
for testing physical property, 356–358
trace of GUR 1050 powder, 358
DiMaio, W.G., 302
2, 2-Diphenyl-1-picrylhydrazyl (DPPH), 434
Direct compression molding (DCM), 14–16
Discover cervical disc, 188
Discovery elbow system, 146–147
Displacement-control wear test, for TKR, 387,
388, 389–390
standardization, 397–398
ISO 14243-3, 397
vs. force-control, 390
Dolezel, B., 238
Dollhopf, W., 277, 281
Doping, 224
Double-blind randomized study, 231
Drucker-stability, 525
DSC. See Differential scanning calorimetry
(DSC)
DSI testing. See Depth-sensing indentation
(DSI) testing
DSM, 256
resin, 12
Dumbleton, J.H., 44, 205, 207
DuPont, 31, 128, 282, 301
Durasul, 295–297
clinical results of, 297
development history, 295–297
packaging of, 296
peer-reviewed studies involving, 299
properties and in vitro performance, 297
Duration stabilized UHMWPE, 205
clinical studies, 207
process of, 206
properties of, 206–207
Durham simulator, 387
Dyneema, 256
E
E-beam. See Electron beam (e-beam)
E-beam irradiation. See Irradiation
ECC. See Extended-chain crystals (ECC)
ECM. See Extracellular matrix (ECM)
“Edge loading wear”, 69–70, 72
EDTA. See Ethylenediaminetetraacetic acid
(EDTA)
Elastic-plastic fracture mechanics, 461–463
Electron beam (e-beam) irradiation, 198
Electron diffraction, 279
Electron pair resonance (EPR), 311
Electron spin resonance (ESR)
basic principle, 434–436
of free radicals
alkyl, 436
allyl, 436–437
peroxy. See Peroxy radicals, ESR
polyenyl, 437
intermediate radicals, 445–446
OIR. See Oxygen-induced radical (OIR)
overview, 433–434
quantitative, 448–449
for testing chemical properties, 363–364
trace, of unsterilized and gamma-sterilized
UHMWPE, 363
of vitamin E, 446–448
Encore, 124
Endo system, 156
Endotoxin, 175
Engh, C.A., Jr., 302
E -Poly HXLPE, 297–298
packaging of, 299
EPR. See Electron pair resonance (EPR)
Equivalent circle diameter (ECD), defined, 415
ESR. See Electron spin resonance (ESR)
ESS. See Ethylene-oxide-sterilized shelf-aged
(ESS) TPI
Ester formation, 315
Ethylene (C2H4 ), structure, 2
Ethylenediaminetetraacetic acid (EDTA), 215
Ethylene oxide (EtO), 201
Ethylene oxide gas (EtO) sterilization, 25–26
Ethylene-oxide-sterilized shelf-aged (ESS)
TPI, 442
EtO. See Ethylene oxide (EtO)
European Committee for Standardization
(CEN), the, 28
Evans, M.A., 12
Ewald, F.C., 81
Exacerbation
of immune response to wear debris due to
subclinical infection, 349
Extended chain crystallization, 278–280
phase diagram for PE, 280–281
Extended-chain crystals (ECC), 279
Extracellular matrix (ECM), 259
Eyerer, P., 326
F
Fang, L., 255
Fatigue crack propagation (FCP), 200
fundamentals, 454–455
testing, 455
viscoelastic, 455–459
Fatigue resistance
concept, 452
cross linking and, 200
defect tolerant approach
FCP. See Fatigue crack propagation
(FCP)
LEFM, 453–454
non-conventional approach, 459–460
total life approach, 452–453
Fatigue small punch test, 493–494
GUR 1050, 494
Fatigue testing, 366
FBA. See Functional biological activity (FBA)
FCP. See Fatigue crack propagation (FCP)
FDA. See Food and Drug Administration (FDA)
FEA. See Finite element analysis (FEA)
FEG-SEM. See Field emission gun-scanning
electron microscopy (FEG-SEM)
Femoral head penetration, radiographic
measurement of
Hip Analysis Suite, 426–428
manual techniques for, 424
overview, 423–424
PolyWare, 428–429
RSA, 424–426
Fernström’s spheres, 172
Fibers, 255–256
HDPE, 252
spectra, 253–254
Fibrocartilage, 348
Field emission gun-scanning electron
microscopy (FEG-SEM), for wear
particles, 412
Finite element analysis (FEA), 282,
479–481
Finite element (FE)-based simulation
methods, 520
First wear testing rig, at Wrightington
Hospital, 36–37
Fischer, E.W., 278
Fixed bearing TKA, 93
Flexion axis, elbow, 141
Flexion moments, knee joints, 386
Flow transition (Tf) temperature, 5
Fluoroscopy, 111
“Fluorosint”, 37
Food and Drug Administration (FDA),
28, 29, 68
guidelines for testing new UHMWPE
material, 355–356
Force-controlled wear test, for TKR, 387
ISO 14243-1 standard, 390
measuring TKR kinematics, 395–397
“quasi-static” theoretical model, 390
soft tissue simulation, 391–395
vs. displacement-control, 390
Fourier transform infrared (FTIR) spectroscopy,
27, 264
for chemical testing, 362–363
spectrometer with microscope, 362
for in vivo oxidation, 329–331
Fourier transform infrared (FTIR) spectroscopy
map
EtO sterilized, shelf-aged UHMWPE
acetabular cup, 318
of gamma sterilized, shelf-aged UHMWPE
acetabular cup, 317
Fracture micromechanism, material
characterization and, 477, 478–479
Fracture resistance
elastic-plastic mechanics, 461–463
Izod and Charpy impact tests, 460–461
J-integral methods, 463–469
concept, 462–463
multi-specimen vs. single-specimen,
463–465
for polymers, 466–467
single-specimen normalization,
465–466
uniaxial tensile test, 460
Freeman-Swanson knee prosthesis, 90
Free radicals, ESR of
alkyl, 436
allyl, 436–437
peroxy. See Peroxy radicals
polyenyl, 437
Frobenius norm, 529
FTIR. See Fourier transform infrared (FTIR)
spectroscopy
Fujiwara, Kunihiko, 240
Fukuoka’s method
3-D/2-D matching of tibial base
plate, 111
Functional biological activity (FBA), 415–416,
419, 420
Fusion assessment, 360–361536 Index
G
GAG. See Glycosaminoglycan (GAG)
Galante, J.O., 250
Gamma-irradiated control (GRM), 442
Gamma irradiation, 198
Gamma irradiation under vacuum (GVF), 164
Gamma sterilization, 198
in air-permeable packaging, 22–23
in barrier packaging, 23–25
Gas plasma (GP), 201
sterilization, 26
Gel permeation chromatography (GPC), 10
for testing physical properties, 360
Geometric knee, 87
Geometric primitives, computer-generated,
512–513
penetration volume measurement, 513
registration of, 513
three-dimensional alignment, 513
uncertainty analysis associated with, 514
Gibbs-Thomson equation, 278
Glass transition (Tg) temperature, 4–5
Gluck, T., 81
Glycosaminoglycan (GAG), 259
Good, Victoria, 306
GP. See Gas plasma (GP)
GPC. See Gel permeation chromatography (GPC)
Greene, Ken, 207
Greer, K., 293, 302
Griffith, M.J., 47–48
GRM. See Gamma-irradiated control (GRM)
Grobbelaar, C.J., 72, 205
Grood, E., 326
Groth, H., 250
Gruner, C.L., 281
GSB. See Gschwend-Scheier-Bahler (GSB)
Gschwend-Scheier-Bahler (GSB), 144
Gul, R., 11
Gunston, F.H., 81–82
work on knee replacements, at
Wrightington, 83–85
GUR 412, 9, 13, 14
GUR 1020, 10, 13, 14, 182
load-displacement curve, 490, 491
GUR 1050, 10, 13, 14, 521–523, 525, 530
biological activity, 416, 417, 419
wear rate, 417
fatigue small punch test, 494
load-displacement curves, 490–491
powder, DSC trace of, 258
GUR 1120 and 1150, 9–10
GUR 1020 GVF, biological activity,
416, 419
wear rate, 417
GUR 4150HP, 9, 12
GUR resins
GUR 412, 9, 13, 14
GUR 1020 and 1050, 10, 13, 14
GUR 1120 and 1150, 9–10
GUR 4150HP, 9, 12
1900 resins and, 10–11
GVF. See Gamma irradiation under vacuum
(GVF)
H
HA. See Hyaluronan (HA); Hydroxyapatite (HA)
HA-CTA, 264–267
structure of, 264–265
Hall, R.M., 48
Halley, D.K., 46
HA-PEX, 255
Harris, W., 295
Harris-Galante acetabular component design,
67
Hatakeyama, T., 279
H-crosslinking, mechanism, 312
HDLs. See High density lipoproteins (HDLs)
HDPE. See High density polyethylene (HDPE)
Hemiarthroplasty, 130
Hendrich, C., 67
Hercules Powder Company, 10, 14
Hertzian contact theory, 101
Hi-Fax 1900 UHMWPE, 10
ram-extruded, 14
High density lipoproteins (HDLs), 232
High density polyethylene (HDPE), 72
fibers, 252
physical and mechanical properties, 3
and UHMWPE wear rates, comparison of, 3
Highly crosslinked UHMWPE, for THA
first-generation, 72–74
historical clinical experience with, 72
second-generation, 74
High-pressure annealing (HPA), 281, 286
High-pressure crystallization (HPC), 277, 281
extended chain crystallization. See
Extended chain crystallization
Hylamer. See Hylamer
radiation crosslinking and, 285–286
HIMONT 1900, 12
HINTEGRA prosthesis, 163–164
Hip Analysis Suite, 426–428
Hip joint replacement, 58, 121, 372
wear resistance of, 224–226
Hip joint simulators
X3 and, 215
Hip replacements, 43. See also Total hip
arthroplasty (THA)
joint replacements and, 44
wear rates. See Wear rates
wear versus wear rate of, 46
Hip resurfacing arthroplasty, 60–61
Hip simulation/simulator
biological factors, 371–372
biomaterial factors in, 372–374
Crossfire, 373
Hylamer, 373
PTFE, 372–373
biomechanical factors in, 369–371
OBM simulator in, 370
standardization for, 375
wear ranking and magnitude, 374
Hip simulator, 416
data, 201
crossfire and, 209
Hip wear reduction dose effect curve, 373
Histomorphologic changes, in periprosthetic
hip tissues, 347–348
Hi Tech Knee II, 240
Hoechst in Germany. See Ticona
Homocomposites
polyethylene, 252
schematic representation of, 253
spectra fibers and, 253–254
Homopolymer, 2
Honeywell, 254, 256
Hood method, 106
Hopper, R. H., Jr., 67
Hospital for Special Surgery (HSS), 89,
326–327
Hot isostatic pressing, ArCom and, 14
Howard, E.G., 282
Howmedica, 85, 89, 206
Hozack, W.J., 44
HPA. See High-pressure annealing (HPA)
HPC. See High-pressure crystallization
(HPC)
Huene Biaxial elbow system, 147
Humeroradial joints, 141
Humeroulnar joints, 141
HYAFF, 262
Hyaluronan (HA), 254–255
compression molding, 265
crosslinking of, 264–265
hydrolysis of, 265
hydrophilicity of, 261, 262–263
lubricity of, 261
medical applications of, 262
silylation of, 263–264
structure of, 261
surface coating of, 265
TGA and, 264
viscoelasticity of, 261
Hyaluronidases, 268
The hybrid model, 527–530
Hybrid Model FEA, 479–481
Hydrogels, 260–261
Hydrogen transfer, to alkyl radical, 311
Hydrolysis, of HA, 265
Hydroperoxide (ROOH), 314
bimolecular thermal decomposition, 315
Hydrophilicity, 261, 267–268
Hydroxyapatite (HA), 163, 255
Hylamer, 281, 373
clinical history of, 31
current perspective, 285
finite element analysis and, 282
hip arthroplasty and, 283–284
knee and, 284–285
properties of, 282
structure of, 282
in vitro studies of, 282–283
Hylamer-M, 283
Hylamer-M
in vitro studies of, 283
Hylan, 262
Hyperelasticity, 524–525
Mooney-Rivlin model, 525
Ogden model, 525
polynomial model, 524–525
Hysteresis energy, and microindentation
testing, 499
I
IB. See Insall-Burstein (IB)
I.B.P. elbow system, 148
ICLH. See Imperial College of London
Hospital (ICLH)
IgG. See Immunoglobulin G (IgG)
Image analysis
software, 513
of wear particles, 412–413
Image-processing program, 517
Immune response
adaptive, 343Index 537
to wear debris
exacerbation due to subclinical
infection, 349
to joint replacement, 343–345
in vitro and in vivo models, 346
Immune system, 342–343
Immunoglobulin G (IgG), 243
Impact testing, 206, 367
Imperial College of London Hospital (ICLH),
156
Implant fabrication, at Wrightington, 35–36
Implant manufacture
postoxidative degradation after, 317
Indentation test
DSI. See Depth-sensing indentation (DSI)
testing
single-asperity wear scratches, 506–508
Inflammatory-based histomorphologic changes,
in periprosthetic tissues, 347–348
Innate immune response, 343
induced by wear debris, 345
Insall, J., 89, 90
Insall-Burstein (IB), 101
Instron-Stanmore Knee Simulator, 392, 393, 402
Intermediate radicals, 445–446
International Organization for Standardization
(ISO), 414
International unit (IU), 229–230
Intrinsic viscosity (IV), 359–360
of UHMWPE, 10
In vitro models
of immune response to wear debris, 346
In vivo absorption, of lipids, 320
In vivo models
of immune response to wear debris, 346
In vivo oxidation
clinical significance of, 331–336
total hip arthroplasty and, 331–333
total knee arthroplasty, 333–336
experimental techniques for studying,
328–331
correlation with mechanical behavior in
retrievals, 331
FTIR spectroscopy, 329–331
institutional procedures and study
design, 328–329
laboratory simulation of, 336–338
overview, 325–326
in 1980s to present, perspective, 326–328
IPA. See Isopropyl alcohol (IPA)
Irradiation
crosslinking efficiency and vitamin E, 245
macroradical formation during, mechanism,
310–311
temperature effects during, 316
Irradiation and melting, 198–199
clinical trials and, 202
crystal structure of UHMWPE and,
199–200
in vivo performance of, 202–203
Irvine ankle prosthesis, 157
Isaac, G.H., 49
ISO. See International Organization for
Standardization (ISO)
ISO 11542, standard for UHMWPE, 2
ISO 14243-1, 390, 401
ISO 14243-2
cleaning and drying protocols, 401
Isolated radicals, crosslinking and reaction of, 311
Isopropyl alcohol (IPA), 232
ISO protocol, 190
Isotropic J2 -plasticity, 526–527
Italy
vitamin E studies, 242–243
Iterative optimization technique, 516
IU. See International unit (IU)
Izod impact test, fracture resistance, 460–461
J
James, S.P., 259, 263, 265
Jani, S., 306
Japan, vitamin E studies from, 240
J-integral methods, 463–469
concept, 462–463
multi-specimen vs. single-specimen,
463–465
for polymers, 466–467
single-specimen normalization, 465–466
J-integral tests, 365
Johnson, N.T., 264
Joint loading, elbow, 141
Joint replacements, 44
UHMWPE development timeline for, 31–32
Journal of the AAOS, 44
K
K55, polymer trade show, 8
Kadaba, M., 207
Kanetsuna, H., 280
Keller, A., 278
Ketone (R2CO), 314–315
Kim, J., 231
Kineflex design, 192
Kircher, J., 71
Knee
Hylamer in, 284–285
simulator, 416–417
Knee arthroplasty, 81. See also Total knee
arthroplasty (TKA)
bicondylar
cruciate sparing, 87–89
total condylar knee, 89–90
clinical performance of
articulating surface damage modes,
105–107
rivision surgery, 103–105
survivorship, 102–103
Frank Gunston work, at Wrightington,
83–85
metal backing, 92
fixed bearing TKA, 93
mobile bearing TKA, 93–94
patello-femoral arthroplasty, 91–92
polycentric, 85–86
polycentric unicondylar (UKAs), 86–87
Knee joint replacement
wear resistance of, 226
Knee wear simulators
contemporary machines, 388–389
data, 201–202
displacement-control test. See
Displacement-control wear test, for TKR
Durham simulator, 387
force-control test. See Force-controlled
wear test, for TKR
history, 386–388
single station hydraulic machine, 386
Stanmore knee simulator, 387
X3 and, 215–216
Kudo elbow system, 147–148
Kurkowski, R.A., 264, 265, 266, 267, 268,
270, 271
Kurtz, S.M., 208, 210, 216
Kwarteng, K., 207
Kyocera, 66, 113
L
Laboratory simulation, of in vivo oxidation,
336–338
Laermer, S.F., 239
Lancet, 34, 38
Langevin function, 527
Latitude total elbow, 146
LCS mobile bearing knees. See Low Contact
Stress (LCS) mobile bearing knees
LDLs. See Low density lipoproteins (LDLs)
LDPE. See Low density polyethylene (LDPE)
LDR Spine, 188
Lederer, Klaus, 241, 242
LEFM. See Linear elastic fracture mechanics
(LEFM)
Leute, U., 277, 281
Lewallen, D.G., 86
LFA. See Low friction arthroplasty (LFA)
Li, S., 281
Linear elastic fracture mechanics (LEFM),
453–454
Linear elasticity, 524
Linear low density polyethylene (LLDPE), 3
Linear viscoelasticity, 525–526
Link Orthopaedics, 161
Lipids. See also Delipidization
in vivo absorption of, 320
Lipopolysacchride (LPS), 349
Livermore, J., 49
Livingston, B.J., 284
LLDPE. See Linear low density polyethylene
(LLDPE)
Longevity, 298–300
clinical results of, 300
development history, 298–300
packaging of, 300
peer-reviewed studies involving, 301
properties and in vitro performance, 300
Low Contact Stress (LCS) mobile bearing
knees, 93–94
Low density lipoproteins (LDLs), 232
Low density polyethylene (LDPE), 3
Low friction arthroplasty (LFA), 34, 67
Lowry, K.M., 268
LPS. See Lipopolysacchride (LPS)
Lubricants, TKR wear test
bovine blood serum, 404–405
ISO standard 14243-1, 405
synovial fluid, 404, 405
Lubricity, of HA, 261
Luketic, D., 238
Lumbar disc arthroplasty, 178–184
Activ-L, 184
contemporary designs, 179
Mobidisc, 183
ProDisc-L, 180–183
Lykins, M.D., 12538 Index
M
Machlin, L., 230
MacIntosh prosthesis, 83
Macroalkyl radicals formation, 310–311
Macroradicals
from oxidation, 314
reaction with stabilizer, 318
Maleic anhydride, 266
Mallory, T.H., 86
Maple, 520
Marathon™, 300–302
clinical results of, 302
development history, 301
peer-reviewed studies involving, 303
properties and in vitro performance, 302
Margolies equation, 10
Mark-Houwink equation, 10
Martell, J.M., 49–50
Massachusetts General Hospital (MGH), 206
Material behavior, a comparison, 521–523
Material characterization, and fracture
micromechanism, 477, 478–479
Material models, 523–524
Material processing, and DSI testing, 501–502
MATLAB, 520
Matrix composites, for orthopedic bearings,
254–255
Matrix metalloproteinase 9 (MMP-9), 226, 243
Max Planck Institute, 8
Mayo Clinic
geometric knee development at, 87
polycentric TKA at, 85–86
polycentric UKAs, 86
Mayo total ankle prosthesis, 158
McGovern, T.F., 23
McKee, G.K., 58
McKee-Farrar prosthesis, 58, 59
McKeever prosthesis, 83
McKellop, H. A., 25, 251, 282, 283, 370
McMinn, D., 60
Mechanical characterization, of notch effects,
476–477, 478
Mechanical properties testing, 365–367
creep analysis, 366–367
fatigue testing, 366
impact testing, 367
J-integral tests, 365
Poisson’s ratio, 365
small punch, 367
tensile testing, 365–366
Medical Devices Agency (MDA), 28
Melting temperature (Tm), 5
Metal backing, knee arthroplasty and, 92
fixed bearing TKA, 93
mobile bearing TKA, 93–94
Metal-on-metal (MOM) bearings, 57
CoCr alloy for, 57–58, 60
designs, second-generation, 59–60
hip resurfacing, 60–61
historical overview, 58
joints, potential biological risks for
metal hypersensitivity, 61
osteolysis in, 61
noise and squeaking from, 72
METASUL (Centerpulse Orthopedics,
Winterthur, Switzerland), 60
MeV. See Million electron volts (MeV)
Meyer, K., 261
MG. See Miller-Gallante (MG)
MGH. See Massachusetts General Hospital
(MGH)
MicroCT
apparatus, 512
third-body wear visualization using, 517
MicroCT scanning, 512
image segmentation in, 512
motion artifacts during, 512
practical considerations in, 512
Microindentation testing. See also Depthsensing indentation (DSI) testing
hysteresis energy, 499
surface preparation, 502–503
Miller-Gallante (MG), 101, 106, 251
Million electron volts (MeV), 198
Miniature specimen mechanical testing,
330–331
Mittelmeier, H., 62
MMP-9. See Matrix metalloproteinase 9
(MMP-9)
Mobi-C, 188
Mobidisc, 183
Mobile bearing TKA, 93–94
Mobility total ankle system, 164
Modular hybrid glenoid, 123
Molding, compression, 13–14
and extrusion, 16–17
Molecular weight distribution, for UHMWPE,
360
MOM bearings. See Metal-on-metal (MOM)
bearings
Monocyte /macrophages, in periprosthetic
tissues, 348
Montedison (Italy), 10
Montell, 10, 11
Mooney-Rivlin model of hyperelasticity, 525
Mosleh, M., 253
Muratoglu, O.K., 12, 283, 295
Muscular anatomy, elbow, 139–140
N
Nakashima, Y., 240
Nanoindentation testing, 502, 503. See also
Indentation test
National Hospital Discharge Survey (NHDS),
44
Nationwide Inpatient Sample (NIS), 153
Natural killer (NK) cells
removal of damaged cells by, 345
role in adaptive immune response, 343
NDI. See Neck Disability Index (NDI)
Neck Disability Index (NDI), 187
Neer prosthesis, 121
Nelder-Mead simplex minimization algorithm,
529
Nelder-Mead simplex optimization algorithm,
517
Net shape compression molding. See Direct
compression molding (DCM)
Nevelos, J.E., 69
New Jersey Cylindrical Replacement, 162
design, 158
New Jersey Low Contact Stress, 162
Newton ankle prosthesis, 156
NHDS. See National Hospital Discharge
Survey (NHDS)
NIF-NaHA, 261
NIS. See Nationwide Inpatient Sample (NIS)
NMR. See Nuclear magnetic resonance (NMR)
NMR spectroscopy. See Nuclear magnetic
resonance (NMR)
Noise, from MOM and COC bearings, 72
Noncontacting video extensometer, 521
Noninflammatory-based histomorphologic
changes, in periprosthetic tissues,
347–348
North American Spine Society, 182
Notch. See also Notched tensile test
and deformation, 481–482
overview, 373–375
stress at, 373–374
triaxial stress state, 375
Notched tensile test
data acquisition, 476
fracture micromechanism, 477, 478–479
Hybrid Model FEA, 479–481
notch effects, 476–477, 478
stress-strain behavior, 476
Nuclear magnetic resonance (NMR), 434
spectroscopy, 264
N2/Vac™
transmission electron micrographs of, 208
O
OA. See Osteoarthritis (OA)
OBM. See Orbital bearing machine (OBM)
Observer uncertainty, 514
Ogden model of hyperelasticity, 525
OIR. See Oxygen-induced radical (OIR)
OIT. See Oxidation induction time (OIT),
measurements
Omnifit series II crossfire study, 211
O-O bond
in ROOH, 314
Oonishi, H., 72, 205
OOT. See Oxidation onset temperature
(OOT)
OPG. See Oprotegerin (OPG)
Oprotegerin (OPG), 348
Optical micrograph, of microtomed UHMWPE
films, 360
OptoTrak 3020 motion system, 175, 177
Oral, E., 245, 285, 286
Orbital bearing machine (OBM), 370
development of, 374–37
photograph of, 371
proteins role in, 371–372
schematic of, 370, 371
Orthopaedic Research Society, 306
Orthopedic bearings
matrix composites for, 254–255
Orthopedic implants, production of
conversion method, 12
ArCom, 16
compression molding, 13–14
compression molding, extrusion versus,
16–17
direct compression molding (DCM),
14–16
hot isostatic pressing, ArCom and, 14
ram extrusion, 14
machining process, 17–18
polymerization, 8
calcium stearate, 11–12
DSM resin, 12Index 539
GUR resins, 9–10
GUR versus 1900 resin, 10–11
molecular weight, 10
1900 resins, 10
Orthopedic prostheses, 316
Orthopedic Research Society, 183
Orthopedic UHMWPE, 310
Orthoplastics Medical, 13, 14
OrthoPOD, wear tester, 271
Osteoarthritis (OA), 118
Osteoarticular anatomy, elbow, 137–139
Osteoclastogenesis, 409
Osteolysis, 44, 409
in MOM hips, 61
TEA, 149–151
wear debris and, 348
Osteolysis, TKA, 107–113
backside wear, 112
damage in PS tibial components, 112–113
incidence of, 107–108
methods to assess in vivo wear in, 108–112
radiographic analyses for, 108
significance of, 107–108
Oswestry Disability Index, 182
Oxford Knee, 93
Oxidation, 312–314
critical products of, 314–315
macroradicals, 314
oxidized products, 314–315
cycle of stabilization by -tocopherol,
313–314
and DSI testing, 503, 505
overview, 312–313
post-irradiation, 313–314
in vivo. See In vivo oxidation
Oxidation induction time (OIT)
measurements, 357
trace, of UHMWPE, 358
Oxidation onset temperature (OOT), 357–358
Oxidation rate of UHMWPE components
factors for, 316
Oxidative stability, 228–229
vitamin E and, 243–244
OXINIUM material, 65
Oxygen-induced radical (OIR), 440–445
growth and decay of, 442
identification of, 442–445
P
Packaging
for Crossfire, 295
of Durasul, 296
of E -Poly HXLPE, 299
of Longevity, 300
Packaging methods
contemporary, Torino survey of, 26–28
gamma sterilization in
air-permeable, 22–23
barrier, 23–25
overview, 21
polymeric materials for, 27
Pae, K.D., 277
Palmer, J., 261
Papain, 411
Pappas, M.J., 93
Parikh, A., 306
Parth, M., 241
Patello-femoral arthroplasty, 91–92
PBS. See Phosphate buffered saline (PBS)
PCA prosthesis, 158
PCL. See Posterior cruciate ligament (PCL)
PCM. See Porous Coated Motion (PCM)
Artificial Disc
PE. See Polyethylene (PE)
Periprosthetic hip tissues
from historical and highly crosslinked
UHMWPE implant retrievals, 349–350
inflammatory-based histomorphologic
changes in, 347–348
monocyte /macrophages in, 348
noninflammatory-based histomorphologic
changes in, 347–348
T cells in, 345
Periprosthetic tissues, and wear particles
centrifugation, 411
delipidization of, 410
digestion of
acids, 410–411
alkalis, 410
enzymes, 411
polarized light microscopy of, 411–412
Peroxy macroradical (ROO), 314 Peroxy radicals, ESR, 437–439 detection of, 439–440 half-life of, 440 Peterson, L.F., 85 Phosphate buffered saline (PBS), 268 Physical property tests, 356–361 density measurements, 361 differential scanning calorimetry (DSC), 356–358 fusion assessment, 360–361 intrinsic viscosity, 359–360 scanning electron microscopy (SEM), 358–359 transmission electron microscopy (TEM), 361 Piekarski, K., 250 Pink dental acrylic cement, implant fixation and, 33 Pin-on-disk (POD) wear test, for TKR, 382–384 ASTM F732 standard, 383 technical considerations, 383–384 Plasticization, 244 Plazlyte (Abtox, Inc., Mundelein, Illinois, USA), 26 PLL. See Posterior longitudinal ligament (PLL) PMMA. See Polymethylmethacrylate (PMMA) Poisson’s ratio, 365 Polialden, 10 Polycentric knee arthroplasty, 85–86 Polycentric knee components, 105 Polycentric UKA, 86–87 Polyenyl radicals, ESR, 437 Polyethylene homocomposites, 252 Polyethylene-hydroxyapatite composites, 255 Polyethylene (PE) creep analysis of, 367 defined, 2–3 hexagonal crystal of, 280 HPA and, 281 HPC and, 281 orthorhombic crystal of, 280 oxygen solubility in, 317 phase diagram for, 280–281 stabilization of, 318 Poly Hi Solidur Meditech, 13, 14 Poly II, 250–252 Polymerization, 8 calcium stearate, 11–12 DSM resin, 12 GUR resins, 9–10 GUR versus 1900 resin, 10–11 molecular weight, 10 1900 resins, 10 Polymers defined, 2 J-integral based methods for, 466–467 Polymethylmethacrylate (PMMA), 119, 127 Polynomial model of hyperelasticity, 524–525 Polyolefins, maleated, 266 Polytetrafluoroethylene (PTFE), 372–373, 439, 490 Charnley’s design of artificial hip joint with fifth and final, 34–35 first, 33 second, interim, 33–34 replacement, search for, 37 Polyurethanes, 260–261 Poly(vinyl chloride) (PVC), 273 PolyWare, 428–429 Porosimetry, mercury, 264 Porous Coated Motion (PCM) Artificial Disc, 186–188 Posterior cruciate ligament (PCL), 98, 201 Posterior longitudinal ligament (PLL), 187 Posterior-stabilized (PS) TKR, 213, 397 Posterior-stabilized (PS) total condylar prosthesis (TCP II), 90, 112–113 Posterior stabilizing (PS) Poly II tibial bearings, 252 Post-irradiation oxidation, of UHMWPE, 313–314 vs. thermal oxidation, 315–318 Postoxidative degradation, after implant manufacture, 317 Posttraumatic arthritis, 126 Potassium hydroxide (KOH), 410 PP2A. See Protein phosphatase 2 A (PP2A) Price, H.C., 252 ProDisc, 180 ProDisc-C in vitro biomechanical testing of, 186 ProDisc-L, 180–183 Prolong, 302–304 development history of, 303 properties and in vitro performance, 303–304 Pronase, 411 Prony series, 526 Prosthetic components, UHMWPE distribution of oxidized compounds in, 316–317 GC/MS analysis of soluble fraction extracted from, 321 Protein phosphatase 2 A (PP2A), 242 Proteins role in OBM, 371–372 Proximal radioulnar joints, 141 PS. See Posterior stabilized (PS); Posterior stabilizing (PS) PTFE. See Polytetrafluoroethylene (PTFE) PVC. See Poly(vinyl chloride) (PVC)540 Index Q Quantitative ESR, 448–449 R Radiation Chemistry of Macromolecules, The, 433 Radiation crosslinking, 198 crystal structure of UHMWPE and, 199–200 dose rate, 201 vitamin E and, 245 Radio-capitellar joints, 141 Radiographic measurement, of femoral head penetration, 429–430 Hip Analysis Suite, 426–428 manual techniques for, 424 overview, 423–424 PolyWare, 428–429 RSA, 424–426 Radiostereometric analysis (RSA), 49, 68, 69, 424–426 Raleigh-Ritz problem, 520 Ramakrishnan, R., 207 Raman spectroscopy, 64 Ram extrusion, 14 compression molding and, 16–17 Ranawat, C.S., 89 Rand, J.A., 87 RANKL, 348 RCH-1000, 3, 38, 48, 84, 85 RCH-1000/ Hostalen GUR 412, 13 R2CHOH. See Sec-alcohol (R2CHOH) R2CO. See Ketone (R2CO) RCOOH. See Carboxylic acid (RCOOH) Rees, D.V., 279, 281 Registration, 512–513 spatial visualization of penetration using manual, 515–516 total disc replacements using automated, 516–517 Relaxation moduli, 526 Repeatability, 514 Reproducibility, 514 1900 resins, 10 GUR resins and, 10–11 Rheumatoid arthritis (RA), 84, 117 Richard Smith ankle joint prosthesis, 156 Rieker, C.B., 60 Ries, M.D., 25 Ring, P.A., 58, 59 Rodriguez, F., 2 ROO. See Peroxy Macroradical (ROO*)
ROOH. See Hydroperoxide (ROOH)
Rostoker, W., 250
RSA. See Radiostereometric analysis (RSA)
Ruhrchemie AG. See Ticona
Russell reaction, 313–314
S
Salto™, 162–163
Salto Talaris™, 162–163
Sanzén’s procedure for fluoroscopy, 111
SBA. See Specific biological activity (SBA)
SB CHARITÉ I, 173
SB CHARITÉ II, 173
SB CHARITÉ III, 173–175
Scandinavian Total Ankle Replacement
(STAR), 161–162
Scanner uncertainty, 514
Scanning electron micrograph
of consolidated UHMWPE, 359
of UHMWPE powder, 359
Scanning electron micrograph (SEM), 264
Scanning electron microscopy (SEM), 251
for testing physical property, 358–359
for wear particles, 412
Schaffner, S., 241
Scheerlinck, T., 56
Schmalzreid, T.P., 283, 284
Schroeder, D., 294
Schwartz Biomedical, LLC, 273
-scission reaction, of secondary radicals, 311
Sclippa, E., 250
Sec-alcohol (R2CHOH), 315
Sedel, L., 62
Self-reinforced composites. See
Homocomposites
SEM. See Scanning electron micrograph (SEM);
Scanning electron microscopy (SEM)
Serekian, P., 207
Shalaby, S.W., 253
Shear punch test, 492–493
Shell Oil (Netherlands), 10
Shoji, H., 85
Shoulder joint, 117–118
Shoulder replacement
biomechanics of, 121–122
clinical performance of, 126–130
loosening, 127–128
overall success rate, 126–127
wear, 128–130
contemporary design, 122–126
controversies in, 130–131
future directions in, 131–132
hemiarthroplasties, 119
history, 120–121
patient age for, 120
patient population, 119–120
procedure, 118–119
prosthesis systems, 122–126
Silicon nitride (Si3N4), for hip arthroplasty,
65–66
Silylation, of HA, 263–264
Simulator lubricants, and wear particles
centrifugation, 411
delipidization, 410
digestion
of acids, 410–411
of alkalis, 410
of enzymes, 411
Single-asperity wear scratches, indentation test,
506–508
Single station hydraulic machine, 386
Sintering, 264
Skolnick, M.D., 86
Sliding microtome, 362
Small Bone Innovations, Inc., 161
Small punch analysis, 367
Small punch test
aging of materials, 487–490
crosslinked materials, 490–492
fatigue, 493–494
metrices, 486–487
objective, 486
shear, 492–493
Smith & Nephew, Inc., 26, 60, 124, 306
OXINIUM material, 65
Smith-Petersen mold arthroplasty, 57–58, 60
Soak controls, in knee wear testing, 401–402
Sodium hydroxide (NaOH), 410
Soft tissue anatomy, elbow, 139
Soft tissue simulation, in force-control wear
test, 391–395
Instron-Stanmore Knee Simulator, 392, 393
ligament constraints, 391
springs
precompression, 391–392
stiffness settings, 392–393
virtual soft tissue concept, 395
Solar elbow system, 146
Song, J., 17
Souter-Strathclyde total elbow, 143
Spatial visualization of penetration using
manual registration, 515–516
Specific biological activity (SBA), 415–416,
419
Spectra fibers, 253–254
Spencer, N.D., 260
Spherulites, 11
Spinnaret, 256
Springs, soft tissue simulation
precompression, 391–392
stiffness settings, 392–393
Squeaking, from MOM and COC bearings, 72
St. Gobain Desmarquest (Vincennes, France),
64, 71
Stabilization
chemical mechanisms of vitamin E, 319
overview, 318–319
Stabilizers, 139, 213
in food packaging, 243
natural, 318
oxidation, 318
reaction with macroradicals, 318
tocopherols as, 238
vitamin E as, 222, 239
Standardization, for hip simulation/simulator,
375
Stanmore knee simulator, 387
STAR. See Scandinavian Total Ankle
Replacement (STAR)
Steric hindrance, UHMWPE irradiation, 311
Sterilization, 272–273
ethylene oxide gas (EtO), 25–26
gamma, 198
in air-permeable packaging, 22–23
in barrier packaging, 23–25
gas plasma, 26
implant sterilization, at Wrightington,
38–39
overview, 21
Sterrad (Advanced Sterilization Products,
Irvine, California, USA), 26
Strain energy density, 524
Streicher, R., 338
“ Stripe wear”, 69
Stryker Howmedica Osteonics, 124
Stryker (Mahwah, New Jersey, USA), 26
Stryker Orthopedics, 304
Stryker Osteonics Corp., 294
Styrofoam, 512Index 541
Subclinical infection
and exacerbation of immune response to
wear debris, 349
Sugano, N., 66
Sulzer Orthopedics
second-generation MOM designs of, 59–60
Sun, D.C., 206
Surface chemistry, 260
Surface coating, of HA, 265
Surface preparation, DSI testing, 502–503
Sutula, L.C., 26
Swarts, D., 12
Swedish Knee Arthroplasty Register, 103
Swell ratio testing
for testing chemical properties, 364–365
Sychterz, C. J., 67, 284, 285
Synovial fluid, in TKR wear test, 404, 405
Synthes, 186
Systemic vitamin exposure, 232
T
TAR. See Total ankle replacement (TAR)
Taylor, S., 207, 294
TBO. See Toluidine blue O (TBO)
T cells, in periprosthetic tissues, 345
TCP. See Total condylar prosthesis (TCP)
TDR. See Total disc replacements (TDR)
TEM. See Transmission electron microscopy
(TEM)
Temperature effects, during irradiation, 316
Tensile properties, of UHMWPE /HA, 269–270
Tensile testing, 365–366
Termination reactions, 313–314
TGA. See Thermogravimetric analysis (TGA)
THA. See Total hip arthroplasty (THA)
Thackray museum in Leeds, 31, 32, 35, 38–39,
45, 48
Thermal oxidation
vs. postirradiation oxidation, 315–317
Thermal transitions
differential scanning calorimetry (DSC), 5
flow transition (Tf) temperature, 5
glass transition (Tg) temperature, 4–5
melting temperature (Tm), 5
Thermal treatment, of radiation crosslinked
UHMWPE, 198
Thermogravimetric analysis (TGA), 264
Thompson Parkridge Richards prosthesis, 157
Thompson prosthesis, 33, 37
Tibial plateau inserts (TPI), 442
Ticona, 8–10, 11, 12, 16
compression molding and, 13
GUR 1020, 160
Time – temperature superposition principle, 526
Tissue responses
rationale for evaluating, 342
Titanium, 163
TKA. See Total knee arthroplasty (TKA)
TKR. See Total knee replacement (TKR)
TNK prosthesis, 159
-tocopherol, 224
Toluidine blue O (TBO), 264, 267
Tomita, Naohide, 240
Tomography, 512. See also MicroCT
Tonino, A., Dr., 207
Torino survey, of contemporary packaging,
26–28, 29
Tornier, 124
Total ankle replacement (TAR)
anatomy, 154
biomechanics of, 154–155
complications analysis, 166–167
contemporary designs
agility total ankle prosthesis, 159–161
BOX prosthesis, 164–165
Buechel-Pappas, 162
HINTEGRA prosthesis, 163–164
Mobility total ankle system, 164
Salto™, 162–163
Salto Talaris™, 162–163
STAR, 161–162
TNK prosthesis, 159
early designs, 156–158
retrieval analysis, 166–167
UHMWPE loading, 165–166
wear in, 165–166
Total condylar knee arthroplasty, 89–90
Total condylar prosthesis (TCP), 90, 106
posterior-stabilized (PS) TCP II, 90
Total disc replacements (TDR)
alternatives to UHMWPE in, 191–192
overview, 172
rim impingement, 189
using automated registration quantitative,
spatial visualization of penetration in,
516–517
in vivo degradation, 188–191
wear in, 188–191
Total elbow arthroplasty (TEA), 137
anatomy, 137–140
muscular anatomy, 139–140
osteoarticular anatomy, 137–139
soft tissue anatomy, 139
biomechanics of, 141
contemporary design, 142–149
Acclaim total elbow, 144–146
Capitellocondylar Prosthesis, 143
Coonrad-Morrey, 143–144
Discovery elbow system, 146–147
GSB III total elbow, 144
Huene Biaxial elbow system, 147
i.B.P. elbow system, 148
Kudo elbow system, 147–148
Latitude total elbow, 146
Solar elbow system, 146
Souter-Strathclyde total elbow, 143
Uni -elbow and rHead, 148–149
implant design, history of, 141–142
osteolysis, 149–151
wear in, 149–151
Total elbow replacement, penetration in, 514–515
spatial visualization of penetration using
manual registration, 515–516
volume penetration, 515
Total hip arthroplasty (THA), 128
bone cement for, 33
Charnley’s design for, with PTFE
fifth and final, 34–35
first, 33
second, interim, 33–34
clinical performance of, 43
joint replacements and, 44
wear, in acetabular components, 45–46, 51
wear measurement, methods for, 49–50
wear versus wear rate, 46–47
COC bearings in. See Ceramic-on-ceramic
(COC) bearings, in THA
gold standard, origins of, 32
highly crosslinked UHMWPE for
first-generation, 72–74
historical clinical experience with, 72
second-generation, 74
hip resurfacing arthroplasty and, 60–61
Hylamer in, 283–284
MOM bearings, 57
CoCr alloy for, 57–58, 60
designs, second-generation, 59–60
hip resurfacing, 60–61
historical overview, 58
joints, potential biological risks for, 61
noise and squeaking from, 72
overview, 31, 40
pink dental acrylic cement, implant fixation
with, 33
PTFE replacement, search for, 37
in vivo oxidation and, 331–333
Wrightington Hospital
first wear testing rig at, 36–37
implant fabrication at, 35–36
implant sterilization at, 38–39
UHMWPE at, 38
Total knee arthroplasty (TKA), 81, 97
alternatives to UHMWPE in, 113–114
backside wear, 112
bicondylar
cruciate sparing, 87–89
Total Condylar knee, 89–90
biomechanics of, 98–102
anatomy, 98
knee joint loading, 98–100
stresses in patellar, 100–102
stresses in tibial, 100–102
ceramic bearings in, 113–114
C-PE bearing for, 113
damage in PS tibial components, 112–113
evolutionary stages for UHMWPE in, 82
Frank Gunston work, at Wrightington, 83–85
highly crosslinked UHMWPE in, 114
IB II component, 112
incidence of osteolysis, 107–108
metal backing, 92
fixed bearing TKA, 93
mobile bearing TKA, 93–94
methods to assess in vivo wear in, 108–112
patello-femoral arthroplasty, 91–92
polycentric, 85–86
significance of osteolysis, 107–108
surface damage in, 106
in vivo oxidation and, 333–336
wear in, 107–113
Total knee replacement (TKR), 381–382
consideration and pitfalls, 398–404
input forces, 402–404
liquid soaking, 401–402
lubricants, 404–405
samples, 400–401
variable control, 398–400
joint coordinate system, 384–386
four-link kinematic chain, 385
hinge mechanism, 385–386
POD test. See Pin-on-disc (POD) wear test,
for TKR
wear simulators. See Knee wear simulators542 Index
Total shoulder arthroplasty (TSA), 118. See
also Total shoulder replacement (TSR)
Total shoulder replacement (TSR)
biomechanics of, 121–122
clinical performance of, 126–130
loosening, 127–128
overall success rate, 126–127
wear, 128–130
contemporary design, 122–126
controversies in, 130–131
future directions in, 131–132
hemiarthroplasties, 119
history, 120–121
patient age for, 120
patient population, 119–120
procedure, 118–119
prosthesis systems, 122–126
Total stabilizer (TS) components, 213
Townley knee, 89
Townley resurfacing prosthesis, 83
Toxicity, vitamin E, 230
effects of, in patients on Warfarin therapy,
231
TPI. See Tibial plateau inserts (TPI)
Trace element analysis, 361–362
Transmission electron micrographs
of consolidated UHMWPE, 361
Crossfire, 208
N2/Vac™, 208
Transmission electron microscopy (TEM), 4
for testing physical property, 361
Triple point, 281
Truss, R.W., 15
TS. See Total stabilizer (TS) components
TSA. See Total shoulder arthroplasty (TSA)
TSR. See Total shoulder replacement (TSR)
Turner, B., 280
Type IV hypersensitivity, 345
U
Ubbelohde viscometer, 359
UHMWPE /HA microcomposite biomaterials.
See also Hyaluronan (HA)
biocompatibility of, 273
biostability, 268
commercialization of, 273
composition, 266–267
crosslinking of, 265
compatibilized, 266
crystallinity in, 268–269
hydrophilicity, 267–268
overview of, 261–263
processing of
compression molding, 265
crosslinking of silylated HA, 264–265
hydrolysis of HA, 265
hydrolysis of silylated HA, 263–265
sintering, 264
solvent infiltration, 264
surface coating, of HA, 265
sterilization of, 272–273
tensile properties of, 269–270
wear rate, 270–271
wear resistance, 270–272
UHMWPE wear debris. See Wear debris
UKA. See Unicondylar knee arthroplasties
(UKA)
Ultrasound for wear assessment in TKA, 111
Unicondylar knee arthroplasties (UKA), 81, 97
polycentric, 86–87
Uni -elbow and rHead, 148–149
Urban, J.A., 67
V
Vinyl double bonds, 311
reaction with secondary radicals, 312
Virtual soft tissue concept, 395
Viscoelastic FCP, 455–459
cyclic mode, 456
peak stress intensity factor (K max),
458–459
static mode, 456–458
Viscoelasticity, of HA, 261
Vitamin E. See also -tocopherol
as antioxidant for polyolefins, 238–239
biocompatibility, 229
toxicity. See Toxicity, vitamin E
content in UHMWPE, determination, 320
crosslinking efficiency and, 245
diffusion of, 223–224
ESR of, 446–448
in food packaging, 239
functions of, 222–223
local effects of, using animal studies,
232–233
mechanical and fatigue strength of
UHMWPE and, 226
adverse conditions, 227–228
mechanical properties of, 244–245
oxidative stability, 228–229, 243–244
plasma levels of, in healthy adults, 231
stabilization mechanism in UHMWPE, 319
studies from Austria, 240–242
studies from Italy, 242–243
studies from Japan, 240
systemic vitamin exposure, 232
tissue levels of, in healthy adults, 231
wear resistance
hip joint replacement, 224–226
knee joint replacement, 226
VITASUL
studies from Austria, 240–242
von Mises stresses
in knee replacement, 101
W
Walker, P.S., 89, 90
Wang, A., 25, 48, 197, 206, 212, 282
Warfarin therapy
vitamin E toxicity and, 231
Warm irradiation with adiabatic melting
(WIAM) process, 453
in Durasul, 297
Waugh, W., 32, 38
Wear debris
chemical properties of, 320–321
immune responses
to joint replacement, 343–345
recent findings and approaches to tissue
analysis, 348–349
in vitro and in vivo models, 346
immune system and, 342–343
osteolysis and, 348
rationale for evaluating tissue responses
to, 342
Wear magnitude, for hip simulation/simulator,
374
Wear measurement methods, in THA
Charnley method, 49
Livermore techniques, 49
Martell technique, 49–51
radiostereometric analysis (RSA), 49
Wear mechanisms, in ceramic bearings, 69–70
Wear particle. See Wear debris
Wear particles
automated particle analysis, 413
biological activity, 415–420
materials, 416
methods, 416–417
volumetric wear rates, 417
image analysis of, 412–413
measurements, 414–415
overview, 409
periprosthetic tissues. See Periprosthetic
tissues, and wear particles
SEM, 412
simulator lubricants. See Simulator
lubricants, and wear particles
standards
ASTM, 414
BSI, 413–414
ISO, 414
Wear ranking, for hip simulation/simulator, 374
Wear rates, 270–271
of acetabular components, 45–46
in Charnley’s and Griffith’s study, 47–48
in clinical and retrieval studies, 49
linear (LWR), 46, 50–51
volumetric (VWR), 46, 50–51
wear versus, of hip replacements, 46
Wear resistance, 270–272
Wear resistance, of vitamin E. See also Vitamin E
hip joint replacement, 224–226
knee joint replacement, 226
Wessex prosthesis, 158
Westlake Plastics, 14
White, R., 231
White, S.E., 25
WIAM. See Warm irradiation with adiabatic
melting (WIAM) process
Widmer, M.R., 260
Wiles, P., 58
Willert, H-G, 342
Wolf, C., 241, 242, 244
Wright, T.M., 250, 282
Wrightington Hospital
first wear testing rig at, 36–37
Gunston work on knee replacements at,
83–85
implant fabrication at, 35–36
implant sterilization at, 38–39
UHMWPE at, 38
Wright Medical Technology, Inc., 26, 60
Wroblewski, B. M., 31, 38, 67, 205
Wunderlich, B., 277, 279
X
X3, 304
clinical studies for, 216
crosslink density for, 213Index 543
free radical concentration for, 213
hip joint simulators and, 215
knee simulators and, 215–216
microstructure of, 214
properties of, 213
oxidation index, 214
tensile, 214
retrievals, 216
sequential crosslinking process, 212–213
survivorship of, 214
Xie, X.L., 254
XLK, 305
XLPE, 305–306
XPS. See X-ray photoelectron spectroscopy
(XPS)
X-ray photoelectron spectroscopy (XPS),
264, 266
Xylene
transient swelling data for UHMWPE
in, 364
Y
Yau, S-S, 212
Y-crosslinking, mechanism, 311
Y-linkages, 198
Young, R.J., 2
Y-TZP (yttria stabilized-tetragonal phase,
polycrystalline zirconia), 64
Z
Zhang, M., 263, 265, 267, 268, 269, 270, 271
Zimmer, Inc., 26, 295
Zirconia-toughened alumina matrix composite
(ZTA), 64–65, 68, 72
Zirconia (ZrO2), for hip arthroplasty
oxidized zirconium, 66
Y-TZP, 64
ZTA, 64–65
ZTA. See Zirconia-toughened alumina
matrix composite (ZTA)
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