Abstract
Total knee arthroplasty is on the rise worldwide. Despite its success, revision surgeries are also increasing. According to the American Joint Replacement Registry 2020, 3.3% of revision surgeries are due to wear, and 24.2% are due to mechanical loosening. The combination of shear stresses and wear particles occurring at the bone/implant interface can lead to local osteolysis. Although the shear stresses are partially driven by joint friction, relatively little is known about the evolution of the coefficient of friction (CoF) during a gait cycle in total knee replacement. Here we describe the CoF during a gait cycle and investigate its association with kinematics (slide–roll-ratio), applied load, and relative velocity. The artificial knee was simulated by cobalt–chromium condyle on a flat ultra-high-molecular-weight polyethylene (UHMWPE) tibial plateau, lubricated by either water or proteinaceous solution. We found that the CoF is not a constant but fluctuates between the values close to 0 and 0.15. Cross-correlation suggested that this is primarily an effect of the slide–roll ratio and the contact pressure. There was no difference in the CoF between water and proteinaceous solution. Knowledge about the CoF behavior during a gait cycle will help to increase the accuracy of future computational models of total knee replacement.
Highlights
Surgery of the knee joint has become one of the most frequent surgeries
coefficient of friction (CoF) between CoCrMo and ultra-high-molecular-weight polyethylene (UHMWPE) is dependent on the availability of protein in the lubricant [19] and applied contact pressure [20,21], we considered the influence of these factors in our experiment
Using the geometric design of a commercially available total knee implant, the velocity between CoCrMo and UHMWPE is dependent on the availability of protein in the lubrivectors in the tibiofemoral contact point on the medial and lateral sides were calculated for cant [19] and applied contact pressure [20,21], we considered the influence of these factors one full gait cycle [15]
Summary
Surgery of the knee joint has become one of the most frequent surgeries. The AmericanJoint Replacement Registry (AJRR) Annual Report, with data on 1,186,955 procedures collected from 2012 through 2017, reflects a 38% increase during that time frame—55.9%of all surgeries were total knee replacement (TKR) surgeries, and 3.8% were revision knee surgeries [1,2]. Surgery of the knee joint has become one of the most frequent surgeries. Joint Replacement Registry (AJRR) Annual Report, with data on 1,186,955 procedures collected from 2012 through 2017, reflects a 38% increase during that time frame—55.9%. Of all surgeries were total knee replacement (TKR) surgeries, and 3.8% were revision knee surgeries [1,2]. The number of TKR surgeries performed annually is rising and is expected to reach 3.48 million in the United States by 2030 [3]. Registry (NJR) for England reports that the number of surgeries increased by 3.8% [4]. The Australian Orthopedic Association National Joint Replacement Registry (AOANJRR). Shows an increasing number of TKR as well. In 2018 alone, knee replacements increased by 1.2% compared with the previous year and revision surgeries comprised 8.7% of all TKR surgeries
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