Revision knee data from six joint arthroplasty centers were compiled for 2010 and 2011 to determine mechanism of failure and time to failure. Aseptic loosening was the predominant mechanism of failure (31.2%), followed by instability (18.7%), infection (16.2%), polyethylene wear (10.0%), arthrofibrosis (6.9%), and malalignment (6.6%). Mean time to failure was 5.9 years (range 10 days to 31 years). 35.3% of all revisions occurred less than 2 years after the index arthroplasty, 60.2% in the first 5 years. In contrast to previous reports, polyethylene wear is not a leading failure mechanism and rarely presents before 15 years. Implant performance is not a predominant factor of knee failure. Early failure mechanisms are primarily surgeon-dependent.

Why Are Total Knees Failing Today? Etiology of Total Knee Revision in 2010 and 2011

Lubrication and wear modelling of artificial hip joints: A review

Biotribology of articular cartilage—A review of the recent advances

After the rapid growth in the use of CoCrMo metal-on-metal hip replacements since the second generation was introduced circa 1990, metal-on-metal hip replacements have experienced a sharp decline in the last two years due to biocompatibility issues related to wear and corrosion products. Despite some excellent clinical results, the release of wear and corrosion debris and the adverse response of local tissues have been of great concern. There are many unknowns regarding how CoCrMo metal bearings interact with the human body. This perspective article is intended to outline some recent progresses in understanding wear and corrosion of metal-on-metal hip replacement both in vivo and in vitro. The materials, mechanical deformation, corrosion, wear-assisted corrosion, and wear products will be discussed. Possible adverse health effects caused by wear products will be briefly addressed, as well as some of the many open questions such as the detailed chemistry of corrosion, tribochemical reactions and the formation of graphitic layers. Nowadays we design almost routinely for high performance materials and lubricants for automobiles; humans are at least as important. It is worth remembering that a hip implant is often the difference between walking and leading a relatively normal life, and a wheelchair.

/pdf/cocrmo-metal-on-metal-hip-replacements-sptn4g47bt.pdf

CoCrMo metal-on-metal hip replacements

https://sensorprod.com/news/white-papers/2009-02_imf/wp_imf-2009-02.pdf

Influence of the meniscus on friction and degradation of cartilage in the natural knee joint.

Effect of conformity and contact stress on wear in fixed-bearing total knee prostheses.

Tribological testing of articular cartilage of the medial compartment of the knee using a friction simulator

Implant malpositioning has been identified as a factor associated with clinical failures of metal-on-metal hip resurfacings (MoMHRs). This study investigated the effect of cup orientation and cup coverage on the contact mechanics (incidence of edge-loading) and range of motion (ROM) of MoMHR. Three generic MoMHRs with differing amounts of cup coverage were considered at various orientations. Contact area and contact pressure at the bearing surface were predicted for each design using finite element (FE) method. The ROM was determined based on the geometry overlap. Edge contact was found at lower angles of inclination (65 degrees) for lower coverage cup designs; however, they also provided the greatest ROM. Conversely, cups with greater coverage did not exhibit edge contact until the cup was more steeply positioned (75 degrees), however ROM was reduced. This study enables both sets of variable to be considered in the design of metal-on-metal bearings in hip.

The effect of cup orientation and coverage on contact mechanics and range of motion of metal-on-metal hip resurfacing arthroplasty.

A full numerical methodology was developed for the elasto-hydrodynamic lubrication analysis of hip joint implants for the lubrication problem in spherical and conformal contacts. Typical results of a metal-on-metal hip implant were obtained to illustrate the applicability of the numerical methodology developed in the present study.Copyright © 2005 by ASME

Elasto-Hydrodynamic Lubrication Modelling of Spherical Metal-on-Metal Artificial Hip Joints

The importance of contact stress in knee hemiarthroplasty design: a tribological simulation

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