title: Nonidentical and outlier duty cycles as factors accelerating UHMWPE wear in THA: a finite element exploration.
abstract: Wear rate and wear direction vary considerably within total hip arthroplasty (THA) patient cohorts. Third body effects and wide-ranging differences in patient activity levels are two factors suspected of contributing to wear variability. A sliding-distance-coupled contact finite element formulation was used to test the hypothesis that nonidentical duty cycles (differing activities, or change of third body challenge) produce accelerations in polyethylene wear. Effects of nonidentical duty cycles, time-variant femoral head roughening, and outlier gait inputs were investigated. Without femoral head roughening, combination walk/stair-climb wear simulations did not result in appreciably higher volumetric wear than a walk-only simulation, but when a roughened zone was included, walk/stair-climb volumetric wear increased by approximately 57% above that of a similarly roughened walk-only simulation. To investigate time-variant femoral head roughening, wear simulations were begun with femoral head roughening at one location on the femoral head, switching to another location halfway through the simulation. Results varied depending on roughening sites, but cases of substantial increase in wear involved a transient jump in wear rate shortly after the change of head roughening location. Outlier duty cycles were simulated by increasing or decreasing the joint contact force and range of motion inputs, to levels at the 97.5th and 2.5th percentiles of a population of normal subjects. The resulting wear showed an increase or decrease closely proportional to the percentage by which each input (force or range of motion) was changed.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Orthopaedic Biomechanics Laboratory, University of Iowa, 2181 Westlawn, University of Iowa, Iowa City, Iowa 52242, USA.
authors.forename: Hannah J
authors.initials: HJ
authors.lastname: Lundberg
authors.forename: Kristofer J
authors.initials: KJ
authors.lastname: Stewart
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Pedersen
authors.forename: John J
authors.initials: JJ
authors.lastname: Callaghan
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Brown
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D005270:Femur Head; D006801:Humans; D008422:Materials Testing / Q000379:methods; D011095:Polyethylenes; D011475:Prosthesis Failure
chemical_list: D011095:Polyethylenes; C111601:ultra-high molecular weight polyethylene