Lubrication model of a knee prosthesis, with non newtonian fluid and porous rough material

Tibial component of knee prostheses, made of ultra high molecular weight polyethylene (UHMWPE), experiences a high degree of wear and may be expected to last twelve years on average. In this work, a steady state one-dimensional lubrication model of a knee prosthesis is solved through a nu-merical technique based on the Finite Element Method. The model takes into account a non Newto-nian synovial fluid, its ultra filtration mechanism and the surface roughness of a porous elastic layer on the tibial component. The benefits of a porous compliant material placed at the top of the metallic tibial component are shown taking into account the stiffness and exudation capacity of the material and hyaluronic acid concentration of synovial fluid.Fil: Berli, Marcelo Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Desarrollo Tecnológico para la Industria Química. Universidad Nacional del Litoral. Instituto de Desarrollo Tecnológico para la Industria Química; Argentina. Universidad Nacional de Entre Ríos. Facultad de Ingeniería; ArgentinaFil: Campana, Diego Martin. Universidad Nacional de Entre Ríos. Facultad de Ingeniería; ArgentinaFil: Ubal, Sebastian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Desarrollo Tecnológico para la Industria Química. Universidad Nacional del Litoral. Instituto de Desarrollo Tecnológico para la Industria Química; ArgentinaFil: Di Paolo, José. Universidad Nacional de Entre Ríos. Facultad de Ingeniería; Argentin

Wear of knee prostheses

This paper describes how three different unique design solutions for artificial knee joints each provide extremely low wear and the potential for a 50-year osteolysis-free lifetime in high-demand patients. Each of the three low-wearing prosthetic design solutions provides a different and distinctive functional solution for the patient and surgeon

Tissue sparing surgery in knee reconstruction: unicompartmental (UKA), patellofemoral (PFA), UKA + PFA, bi-unicompartmental (Bi-UKA) arthroplasties

Recently mini-invasive joint replacement has become one of the hottest topics in the orthopaedic world. However, these terms have been improperly misunderstood as a “key-hole” surgery where traditional components are implanted with shorter surgical approaches, with few benefits and several possible dangers. Small implants as unicompartmental knee prostheses, patellofemoral prostheses and bi-unicompartmental knee prostheses might represent real less invasive procedures: Tissue sparing surgery, the Italian way to minimally invasive surgery (MIS). According to their experience the authors go through this real tissue sparing surgery not limited only to a small incision, but where the surgeons can respect the physiological joint biomechanics

A circumferentially flanged tibial tray minimizes bone-tray shear micromotion

Aseptic loosening of the tibial component is the major complication of total knee arthroplasty. There is an association between early excessive shear micromotion between the bone and the tray of the tibial component and late aseptic loosening. Using non-linear finite element analysis, whether a tibial tray with a circumferentially flanged rim and a mating cut in the proximal tibia could minimize bone-tray shear micromotion was considered. fifteen competing tray designs with various degrees of flange curvature were assessed with the aim of minimizing bone-tray shear micromotion. A trade-off was found between reducing micromotion and increasing peripheral cancellous bone stresses. It was found that, within the limitations of the study, there was a theoretical design that could virtually eliminate micromotion due to axial loads, with minimal bone removal and without the use of screws or pegs

The Knee Arthroplasty Trial (KAT) : design features, baseline characteristics and two-year functional outcomes after alternative approaches to knee replacement

Background: The aim of continued development of total knee replacement systems has been the further improvement of the quality of life and increasing the duration of prosthetic survival. Our goal was to evaluate the effects of several design features, including metal backing of the tibial component, patellar resurfacing, and a mobile bearing between the tibial and femoral components, on the function and survival of the implant. Methods: A pragmatic, multicenter, randomized, controlled trial involving 116 surgeons in thirty-four centers in the United Kingdom was performed; 2352 participants were randomly allocated to be treated with or without a metal backing of the tibial component (409), with or without patellar resurfacing (1715), and/or with or without a mobile bearing (539). Randomization to more than one comparison was allowed. The primary outcome measures were the Oxford Knee Score (OKS), Short Form-12, EuroQol-5D, and the need for additional surgery. The results up to two years postoperatively are reported. Results: Functional status and quality-of-life scores were low at baseline but improved markedly across all trial groups following knee replacement (mean overall OKS, 17.98 points at baseline and 34.82 points at two years). Most of the change was observed at three months after the surgery. Six percent of the patients had additional knee surgery within two years. There was no evidence of differences in clinical, functional, or quality-of-life measures between the randomized groups at two years. Conclusions: Patients have substantial improvement following total knee replacement. This is the first adequately powered randomized controlled trial, of which we are aware, in which the effects of metal backing, patellar resurfacing, and a mobile bearing were investigated. We found no evidence of an effect of these variants on the rate of early complications or on functional recovery up to two years after total knee replacement. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.NIHR Health Technology Assessment Programme (Project Number 95/10/01); Howmedica Osteonics; Zimmer; DePuy, a Johnson and Johnson company; Corin Medical; Smith and Nephew Healthcare. Biomet Merck; and Wright CremascoliPeer reviewe

No differences in in vivo kinematics between six different types of knee prostheses

Purpose: The aim of this study was to compare a broad range of total knee prostheses with different design parameters to determine whether in vivo kinematics was consistently related to design. The hypothesis was that there are no clear recognizable differences in in vivo kinematics between different design parameters or prostheses. Methods: At two sites, data were collected by a single observer on 52 knees (49 subjects with rheumatoid arthritis or osteoarthritis). Six different total knee prostheses were used: multi-radius, single-radius, fixed-bearing, mobilebearing, posterior-stabilized, cruciate retaining and cruciate sacrificing. Knee kinematics was recorded using fluoroscopy as the patients performed a step-up motion. Results: There was a significant effect of prosthetic design on all outcome parameters; however, post hoc tests showed that the NexGen group was responsible for 80% of the significant values. The range of knee flexion was much smaller in this group, resulting in smaller anterior-posterior translations and rotations. Conclusion: Despite kinematics being generally consistent with the kinematics intended by their design, there were no clear recognizable differences in in vivo kinematics between different design parameters or prostheses. Hence, the differences in design parameters or prostheses are not distinct enough to have an effect on clinical outcome of patients.Biomechanical EngineeringMechanical, Maritime and Materials Engineerin

Four Station Knee Simulator Wear Testing Comparing Titanium Niobium Nitride with Cobalt Chrome

A new non-destructive method was applied in order to assess bone integrity. The method is based on measurement of bHypersensitivity to an orthopaedic implant was first published in 1966 and since then, in sensitive patients, is known to cause serious problems in joint replacement surgery. Titanium niobium nitride (TiNbN) can act as a surface coat for knee arthroplasty to “hide” the cobalt chrome (CoCr) femoral component beneath, therefore affording an immunoprivileged state. The aim of this study is to determine the wear properties of titanium niobium nitride against Ultra High Molecular Weight Polyethylene (UHMWPE) compared to cobalt chrome and to examine the metallic alloy surface of knee prostheses after loading cycles using a knee simulator. Three TiNbN coated and one CoCr Vanguard total knee femoral components were articulated against standard UHMWPE grade tibial inserts in the Stanmore-Instron knee simulator. Surface roughness, UHMWPE mass, lowest point, surface profiles and volumetric change were measuredevery one million cycles up to five million cycles. After five million cycles the average roughness of the cobalt chromemedial and lateral femoral condyles was over three times that of the TiNbN coated femoral condyles. There was no obvious difference in weight loss, volume loss or progression of lowest points of the tibial inserts articulating with the TiNbN coated and the cobalt chrome femoral component. Despite a clear reduction in roughness progression over the course of this in vitro test, there was no demonstrable improvement in UHMWPE wear measured gravimetrically or by surface profiling. The TiNbN implant tested may still be of great benefit to patients who are metal sensitive, but the coat offers no benefit in UHMWPE wear

A procedure for total knee alignment prosthesis using the ICP algorithm in the aim to implant it in the biomechanical engineering

It isn’t exceptional that in orthopedic surgery, the surgeon observes during his intervention the important deformations in the knee, like a bad leg orientation, collapse of some bone surfaces, shortening or lengthening ligaments etc. That makes it sometimes necessary to make complementary gestures like lengthen a ligament, adapt a bones cut, in order, to have a best knee performance. The join an implant system associated with a revision instrument of total knee prosthesis (PTG) causes the navigation system to produce a perfect alignment, stability and functional results that are both reliable and precise. In this paper, a procedure which uses the ICP (Iterative Closest Point) algorithm for total knee alignment prosthesis is proposed in order to improve the current technique and thus avoid the revision surgery of total knee prostheses

A rolling-gliding wear simulator for the investigation of tribological material pairings for application in total knee arthroplasty

<p>Abstract</p> <p>Background</p> <p>Material wear testing is an important technique in the development and evaluation of materials for use in implant for total knee arthroplasty. Since a knee joint induces a complex rolling-gliding movement, standardised material wear testing devices such as Pin-on-Disc or Ring-on-Disc testers are suitable to only a limited extent because they generate pure gliding motion only.</p> <p>Methods</p> <p>A rolling-gliding wear simulator was thus designed, constructed and implemented, which simulates and reproduces the rolling-gliding movement and loading of the knee joint on specimens of simplified geometry. The technical concept was to run a base-plate, representing the tibia plateau, against a pivoted cylindrical counter-body, representing one femur condyle under an axial load. A rolling movement occurs as a result of the friction and pure gliding is induced by limiting the rotation of the cylindrical counter-body. The set up also enables simplified specimens handling and removal for gravimetrical wear measurements. Long-term wear tests and gravimetrical wear measurements were carried out on the well known material pairings: cobalt chrome-polyethylene, ceramic-polyethylene and ceramic-ceramic, over three million motion cycles to allow material comparisons to be made.</p> <p>Results</p> <p>The observed differences in wear rates between cobalt-chrome on polyethylene and ceramic on polyethylene pairings were similar to the differences of published data for existing material-pairings. Test results on ceramic-ceramic pairings of different frontal-plane geometry and surface roughness displayed low wear rates and no fracture failures.</p> <p>Conclusions</p> <p>The presented set up is able to simulate the rolling-gliding movement of the knee joint, is easy to use, and requires a minimum of user intervention or monitoring. It is suitable for long-term testing, and therefore a useful tool for the investigation of new and promising materials which are of interest for application in knee joint replacement implants.</p