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Quantitative ultrahigh-molecular-weight polyethylene wear in total elbow retrievals
Journal article   Open access   Peer reviewed

Quantitative ultrahigh-molecular-weight polyethylene wear in total elbow retrievals

Judd S. Day, Daniel W. MacDonald, Matthew L. Ramsey, Joseph A. Abboud and Steven M. Kurtz
Journal of shoulder and elbow surgery, v 29(11), pp 2364-2374
01 Nov 2020
DOI: https://doi.org/10.1016/j.jse.2020.03.026
PMID: 32666923
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.jse.2020.03.026View
Accepted (AM)Open Access (Publisher-Specific),  Open

Abstract

Life Sciences & Biomedicine Orthopedics Science & Technology Sport Sciences Surgery
Background: The purpose of this study was to evaluate ultrahigh-molecular-weight polyethylene (UHMWPE) wear and damage from retrieved total elbow arthroplasty components and compare in vivo wear with wear produced in vitro. Methods: Explanted total elbow components were collected at revision surgery. UHMWPE damage was characterized visually, whereas penetration and wear were quantified using micro-computed tomography and gas pycnometry. Volumetric wear rates were compared with historical hip data, and wear data were compared with reported in vitro wear test data. Results: Humeral bushing damage primarily occurred in the form of burnishing, scratching, and pitting at the articular face in the region of contact with the ulnar component. Wear of the ulnar bushings was concentrated on the edge of the component at the point of contact with the axis pin. Pitting and embedded debris were dominant damage modes, in addition to burnishing and delamination. Backside wear was negligible. The median linear penetration rates of the lateral, medial, and ulnar bushings were 0.14 mm/yr (range, 0.01-0.78 mm/yr), 0.12 mm/yr (range, 0.03-0.55 mm/yr), and 0.11 mm/yr (range, 0.01-0.69 mm/yr), respectively. The volumetric wear rates of the lateral, medial, and ulnar bushings were 5.5 mm(3)/yr (range, 0.7-37.2 mm(3)/yr), 5.9 mm(3)/yr (range, 0.6-25.5 mm(3)/yr), and 5.5 mm(3)/yr (range, 1.2-51.2 mm(3)/yr), respectively. Conclusions: The observed wear rates were similar to those reported in well-functioning total hip replacement patients with conventional UHMWPE bearings. We found limitations in reported in vitro testing resulting in wear that was not consistent with our retrieval data. We recommend further investigation to clinically validate in vitro simulation to provide appropriate loading protocols for elbow wear simulation. (C) 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

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Collaboration types
Industry collaboration
Domestic collaboration
Web of Science research areas
Orthopedics
Sport Sciences
Surgery
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