Abstract

Total disc replacement (TDR) is a modern technique employed to treat degenerative disc disease that has the benefit of preserving motion compared with the clinically established spinal fusion. The wear performance of implants based on articulating designs is a key factor that determines their longevity and it is hypothesized that this will be the case for TDR devices. A detailed analysis of the surface of Charité lumbar disc replacements during simulated wear for five million cycles (MC), with inputs defined by the ISO18192-1 standard, is presented. After each million cycles the disc asperity heights, asperity curvature radii and their distributions on the surface of the core of the implant were determined at different locations. Two distinct areas on the surface of Charité polyethylene disc were identified based on the surface topography change during the wear simulation process. Within the area corresponding to the dome the initial roughness decreased, but after 2 MC the surface appeared to roughen with material build-up. More peripherally on the dome the surface roughness decreased after the first MC and remained constant. No effect was noticed on the rim. Furthermore, no statistical difference was noticed between the inferior and superior sides of the core of the disc. The study demonstrated that the wear on the two surfaces of the disc was uneven. This spatial variation is important in modelling the wear processes and providing strategies for reducing wear through enhanced design and modifications to the biotribological properties of the device.

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