title: Surface grafting of biocompatible phospholipid polymer MPC provides wear resistance of tibial polyethylene insert in artificial knee joints.
abstract: OBJECTIVE
  Aseptic loosening of artificial knee joints induced by wear particles from a tibial polyethylene (PE) insert is a serious problem limiting their longevity. This study investigated the effects of grafting with our original biocompatible phospholipid polymer 2-methacryloyloxyethyl phosphorylcholine (MPC) on the insert surface.
  
  
  METHODS
  The hydrophilicity of the PE surface was determined by the contact angle of a water droplet, and the friction torque was measured against a cobalt-chromium alloy component. The wear amount was compared among PE inserts with or without cross-linking and MPC grafting during 5x10(6) cycles of loading in a knee joint simulator. The surfaces of the insert and the wear particles in the lubricant were subjected to electron and laser microscopic analyses. The mechanical properties of the inserts were evaluated by the small punch test.
  
  
  RESULTS
  The MPC grafting increased hydrophilicity and decreased friction torque. In the simulator experiment, the wear of the tibial insert was significantly suppressed in the cross-linked PE (CLPE) insert, and even more dramatically decreased in the MPC-grafted CLPE insert, as compared to that in the non-cross-linked PE insert. Surface analyses confirmed the wear resistance by the cross-linking, and further by the MPC grafting. The particle size distribution was not affected by cross-linking or MPC grafting. The mechanical properties of the insert material remained unchanged during the loading regardless of the cross-linking or grafting.
  
  
  CONCLUSIONS
  Surface grafting with MPC polymer furnished the PE insert with wear resistance in an artificial knee joint through increased hydrophilicity and decreased friction torque.
authors.affiliation: Department of Science for Joint Reconstruction, The University of Tokyo, Tokyo, Japan. moro-ort@h.u-tokyo.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Moro
authors.forename: Y
authors.initials: Y
authors.lastname: Takatori
authors.forename: M
authors.initials: M
authors.lastname: Kyomoto
authors.forename: K
authors.initials: K
authors.lastname: Ishihara
authors.forename: K
authors.initials: K
authors.lastname: Saiga
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.forename: H
authors.initials: H
authors.lastname: Kawaguchi
mesh_terms: D001672:Biocompatible Materials / Q000737:chemistry*; D003432:Cross-Linking Reagents; D006801:Humans; D007595:Joint Prosthesis; D007719:Knee Joint; D008422:Materials Testing; D008689:Methacrylates; D046529:Microscopy, Electron, Transmission; D010767:Phosphorylcholine / Q000031:analogs & derivatives; D013499:Surface Properties
chemical_list: D001672:Biocompatible Materials; D003432:Cross-Linking Reagents; D008689:Methacrylates; D010767:Phosphorylcholine; C070638:2-methacryloyloxyethyl phosphorylcholine