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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Problems associated with premature failure of total knee replacements (TKR's) include: wear, creep, and oxidation of ultrahigh-molecular-weight polyethylene (UHMWPe) as well as adverse tissue reactions to polyethylene wear debris. These problems are associated in part with the mechanical behavior of UHMWPe. In TKR's, contact stress analyses have been performed on the UHMWPe tibial component; however, most have employed simplified material properties and not accounted for joint kinematics. A nonlinear viscoelastic rolling model was developed for TKR's to predict the contact stress and rolling friction for varying rolling speed, conformity, applied load, and tibial plateau thickness. Results indicated that the contact stress increased and rolling friction decreased with increasing rolling speed. Effects of conformity, applied load, and tibial plateau thickness were consistent with previous models. At large rolling speeds, predicted peak contact stresses were almost twice their static value, resulting in a compound fatigue problem in UHMWPe components due to normal cyclic loading, moving point of contact, and velocity-dependent stresses.
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PMID:Dynamic contact stress and rolling resistance model for total knee arthroplasties. 928 38

Severe loading and complex kinematics in total knee replacement make wear performance and toughness of the polyethylene in tibial inserts important. We investigated wear of crosslinked polyethylene using a knee simulator and measured toughness using small-punch testing. GUR1050 rods were gamma-irradiated in air at doses from 0 to 200 kGy, annealed in nitrogen, and machined into tibial inserts. The simulator was run to 4 million cycles, and wear rates determined from weight loss. Wear rate decreased by 54, 78, and 95% as radiation dose increased from 50 to 75 to 100 kGy, respectively. At every dose, toughness was significantly less after simulator testing, but the difference between control and wear-tested polyethylene, considered to be due to fatigue damage accumulation, was smallest at 50 kGy. The simulator-tested polyethylene that received 35 to 75 kGy had slightly higher toughness than equivalent material that received no irradiation. However, the toughness of simulator-tested polyethylene that received 150 and 200 kGy was lower than that of the simulator-tested polyethylene that received no irradiation. Our results suggest that an optimal irradiation dose may exist for crosslinked polyethylene for use in TKR and that the optimum dose would be less than the 100 kGy or more that are used in some current crosslinked polyethylene for hip replacement.
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PMID:Wear and toughness of crosslinked polyethylene for total knee replacements: a study using a simulator and small-punch testing. 1689 91

Highly crosslinked polyethylene (HXPE) has been shown to be effective in reducing wear in total hip replacements. HXPE has not found widespread use in TKR, because the crosslinking inevitably leads to reductions in critical properties such as toughness and fatigue strength. Sequentially enhanced crosslinking (SXPE) have been suggested for improved wear resistance for tibial inserts with maintenance of mechanical properties and anticipated high oxidation resistance superior to conventional polyethylene (XLPE). We compared the wear of SXPE (9Mrad) to XLPE inserts (3Mrad) to 10 million cycles. Triathlon femoral condyles were identical in both. This is the first wear study of SXPE inserts. According to the power law relating irradiation dose to wear of XLPE inserts, wear of 9 Mrad inserts should be reduced by 70% compared to 3Mrad controls. The wear rates of the SXPE inserts were reduced by 86% at 10 million cycles duration, somewhat greater than predicted. The one prior investigation by the manufacturer reported a 79% wear reduction for SXPE compared to controls in a 5 million cycle simulator study in knee design and test parameters. There were important differences between the two studies. Nevertheless there clearly appeared to be a major benefit for sequentially enhanced polyethylene in tibial inserts. This combined wear reduction of 80-85% with improved oxidation resistance and retention of mechanical properties may prove beneficial for active patients who may otherwise risk high wear rates over many years of use.
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PMID:Wear of sequentially enhanced 9-Mrad polyethylene in 10 million cycle knee simulation study. 1809 96