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  • 1. Affatato, S.
    et al.
    Leardini, W.
    Jedenmalm, Anneli
    KTH, School of Industrial Engineering and Management (ITM), Materials Science and Engineering.
    Ruggeri, O.
    Toni, A.
    Larger diameter bearings reduce wear in metal-on-metal hip implants2007In: Clinical Orthopaedics and Related Research, ISSN 0009-921X, E-ISSN 1528-1132, no 456, p. 153-158Article in journal (Refereed)
    Abstract [en]

    Metal-on-metal hip arthroplasty has the longest clinical history of all total arthroplasties. We asked whether large diameter femoral heads would result in less wear than those with small diameters. We also asked if there is a threshold diameter that ensures good wear behavior. We tested three batches of cast high-carbon cobalt-chromium-molybdenum hip implants (28 mm, 36 min, and 54 min diameters) in a hip simulator for 5 million cycles. We used bovine serum as lubricant and weighed the samples at regular intervals during testing. The 28-mm configuration had almost twice the wear of the 54-mm configuration, but we observed no difference between the 36-mm and the 54-mm configurations. The similarity in the wear performances of the larger configurations supports the presence of a threshold diameter that ensures good wear behavior.

  • 2. Affatato, S.
    et al.
    Leardini, W.
    Jedenmalm, Anneli
    KTH, School of Industrial Engineering and Management (ITM), Materials Science and Engineering.
    Zavalloni, M.
    Ruggeri, O.
    Tarterini, F.
    Viceconti, M.
    Microstructural effects on the wear resistance of CO-CR implant alloys2006In: Proceedings of the 8th Biennial Conference on Engineering Systems Design and Analysis, 2006, p. -951Conference paper (Refereed)
    Abstract [en]

    Modem metal-on-metal articulation have been proposed to reduce the incidence of osteolysis due to polyethylene particles debris, as a late complication. The tribology of large metal-on-metal articulations allows theoretical advantages with respect to other configurations, especially for the lubrication regime. This study was aimed to compare the wear performances of different diameters of clinically available acetabular metallic components manufactured in a cast cobalt-chrome alloy. To evaluate the influence of the material properties of wear and microstructure, metal-on-metal components were tested in a hip joint simulator for five million cycles with bovine calf serum as lubricant. In particular, three different configurations of metal-on-metal components (28-mm, 36-mm, 54-mm) were tested. After the test all specimens were examined with optical and electronic scanning microscope. A statistical difference were observed among the three groups tested in the run-in and steady-state wear rates, favoring the larger femoral heads. The results of this study indicate that the 54-mm diameter femoral heads prove a better wear behavior than the smaller configurations.

  • 3.
    Hoseini, Mohammed
    et al.
    SP Swedish National Testing and Research Institute, Transport and Vehicle Technology, Building Technology and Mechanics, Borås.
    Jedenmalm, Anneli
    KTH, School of Industrial Engineering and Management (ITM), Materials Science and Engineering, Mechanical Metallurgy.
    Boldizar, Antal
    Department of Materials and Manufacturing Technology, Chalmers University of Technology, Göteborg.
    Tribological investigation of coatings for artificial joints2008In: Wear, ISSN 0043-1648, E-ISSN 1873-2577, Vol. 264, no 11-12, p. 958-966Article in journal (Refereed)
    Abstract [en]

    A modified pin-on-disc machine was used for the tribological investigation of ultrahigh molecular weight polyethylene (UHMWPE) sliding on stainless steel or stainless steel coated with diamond-like carbon, titanium nitride or Micronite. Micronite is a new type of coating applied by a physical vapour deposition technique combined with a very low friction coating material giving improved tribological properties. The tribological parameters used were chosen to mimic the conditions prevailing in the human body. The wear debris and the counter-surfaces were analysed. The surface analysis showed that the coating changed the roughness of the counter-surfaces. The diamond-like carbon and Micronite coatings had a much higher surface roughness than the titanium nitride coating. The results indicated that the enhanced tribological behaviour of the Micronite/UHMWPE sliding pair might be used as a material combination in artificial joints. Further studies are however required in order to support this.

  • 4.
    Jedenmalm, Anneli
    KTH, School of Industrial Engineering and Management (ITM), Materials Science and Engineering.
    Assessment of acetabular cup wear with computed tomography and influence of surface roughness on wear of materials for hip prostheses2006Licentiate thesis, comprehensive summary (Other scientific)
    Abstract [en]

    Over one million hip prostheses are implanted in patients worldwide each year and the need is increasing as the patient group of younger and more active patients is increasing. Many parameters affect the longevity of the implant, where aseptic loosening caused by wear debris is the most common reason for revision. To be able to monitor wear in vivo and also to predict the longevity of new materials for hip prostheses are therefore important issues in this interdisciplinary research area. This thesis comprise a true non-invasive 3D method for determination of acetabular cup wear using Computed Tomography (CT) intended for clinical routine use in order to plan for a revision. It also comprises investigations of the influence of surface roughness and sterilization method in wear testing of materials for hip prostheses. Mainly wear of ultra high molecular weight polyethylene (UHMWPE) was investigated since it is the most common soft bearing in hip prostheses. The 3D-CT method was found to be easy to use and showed an accuracy and repeatability at a clinical relevant level for acetabular cup wear. It should lend itself well to semi-automation. The influence of surface roughness was investigated with both a multidirectional pin-on-disk machine and with a hip simulator. A new low friction coating, Micronite, was also evaluated with the pin-on-disk machine. This coating showed potential for use in artificial joints, but further investigations are needed. In the hip simulator test, it was found that not only a rougher counter surface increased wear, but also sterilization by γ-irradiation increased wear of UHMWPE cups.

  • 5.
    Jedenmalm, Anneli
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Computed Tomography of Acetabular Cup Wear and Effect of Surface Roughness on Wear and Oxidation of UHMWPE Hip Prostheses2007Doctoral thesis, comprehensive summary (Other scientific)
    Abstract [en]

    Aseptic loosening is the most common complication in total hip replacement (5- 10% at 10 years follow up). The magnitude of the problem is illustrated by the fact that about one million hip prostheses are implanted worldwide each year. Many parameters affect the longevity of the implant where aseptic loosening caused by wear debris and raised intraarticular pressure are the most common reasons for revisions. To monitor wear in vivo and also to predict the longevity of new materials for hip prostheses are therefore important issues.

    The main aims of this thesis are to validate a new non-invasive method for assessment of in vivo wear of acetabular cups in 3 dimensions using computed tomography (CT), and to investigate the influence of counterface surface roughness and γ-irradiation sterilisation in wear testing of ultra high molecular weight polyethylene (UHMWPE) for hip prostheses. A new low friction coating, Micronite was also investigated using a multidirectional pin-on-disk machine.

    The 3D-CT method was found to be easy to use and showed an accuracy and repeatability at a clinical relevant level for assessment of acetabular cup wear. The method should lend itself well to semi-automation. The Micronite coating showed potential for use in artificial joints due to its low friction and intact surface after wear testing compared to a stainless steel disk that showed wear tracks. However, the surface roughness of the stainless steel disks was increased by the coating. Therefore further investigations are needed. In the hip simulator study, it was found that a rougher counter surface increased the wear 2-fold. It was also found that sterilisation by γ-irradiation (in nitrogen) increased both fluid absorption and wear of the UHMWPE cups compared to the non-sterilised cups. A study with infrared spectroscopy and derivatisation techniques using NO, HCl, and SO2 showed that the increased wear and absorption were due to oxidation induced by γ-irradiation. The oxidation was found to be inhomogeneous with higher oxidation near the surfaces. The contribution of the roughened heads to the increased oxidation was only minor. Crystallinity changes upon wear testing of the sterilised cups were detected with Raman spectroscopy and differential scanning calorimetry. However, the changes were small and the influence on wear properties is therefore questionable.

  • 6.
    Jedenmalm, Anneli
    et al.
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Affatato, S.
    Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna.
    Taddei, P.
    Centro di Studio Sulla Spettroscopia Raman, Dipartimento di Biochimica G. Moruzzi, Università di Bologna, Bologna.
    Leardini, W.
    Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna.
    Gedde, Ulf
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Fagnano, C.
    Centro di Studio Sulla Spettroscopia Raman, Dipartimento di Biochimica G. Moruzzi, Università di Bologna, Bologna.
    Viceconti, M.
    Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna.
    Effect of head surface roughness and sterilization on wear of UHMWPE acetabular cups2009In: Journal of Biomedical Materials Research, ISSN 0021-9304, E-ISSN 1097-4636, Vol. 90, no 4, p. 1032-1042Article in journal (Refereed)
    Abstract [en]

    The impact of femoral head surface roughness on wear of gamma-irradiation sterilized (3 MRad in nitrogen, crosslinked) and nonsterilized (not crosshnked) UHMWPE acetabular cups has been evaluated. Gravimetric wear testing was performed in a hip joint simulator for 2 x 10(6) cycles. CoCrMo heads were used with different surface roughness (R-a = 15 nm and R-a = 400 rim). The surface roughness after wear test was unchanged for the roughened heads, whereas the initially smooth heads showed a few scratches. The roughened heads increased the wear of the acetabular cups 2-fold. The gamma-irradiated cups tested against rough heads underwent the highest wear. The absorption of water was highest for the gamma-irradiated cups (0.0204% compared to 0.0031% after 85 days). Raman spectroscopy showed small but significant crystallinity changes in the wear zone, where the gamma-irradiated cups with the most extensive abrasion increased in crystallinity, whereas the nonsterilized cups underwent a crystallinity decrease.

  • 7.
    Jedenmalm, Anneli
    et al.
    KTH, School of Industrial Engineering and Management (ITM), Materials Science and Engineering.
    Leardini, Walther
    Laboratorio di Tecnologia Medica, Istititi Ortppedci Rizzoli, Bologna.
    Zavalloni, Mara
    Laboratorio di Tecnologia Medica, Istititi Ortppedci Rizzoli, Bologna.
    Affatato, Saverio
    Laboratorio di Tecnologia Medica, Istititi Ortppedci Rizzoli, Bologna.
    Effect of head surface roughness and sterilization method on wear of UHMWPE acetabular cups: preliminary hip joint simulator results2006In: Proceedings of 8th Biennial ASME Conference on Engineering Systems Design and Analysis, ESDA2006, Vol. 3, 2006Conference paper (Refereed)
    Abstract [en]

    More than one million hip joint replacements are performed each year in the world. However, the implants do not last forever due to material limitations, even though the operation is successful. The most common material combination used today is a CoCr head articulating against an UHMWPE (Ultra High Molecular Weight Polyethylene) acetabular cup. Several investigations have shown that the metal head is roughened inside the body and thus accelerating wear of the polymer cup. The sterilization method is also known to have effect on the wear properties. In vitro wear tests are however usually performed with as new implants. This investigation aimed at study the impact of head surface roughness on wear of both sterilized and non-sterilized acetabular cups. A total of nine acetabular cup and head pairs were wear tested in a hip joint simulator for 2Million cycles (Mc) with bovine calf serum as lubricant. Wear was determined by weighing of all cups. The heads were of CoCrMo and the average initial head surface roughness was 15nm (R-a), measured with a white light interference profilometer. The roughening was produced with a SiC paper producing circular multidirectional wear tracks to a surface roughness of about 400nm (R-a). The cups were of UHMWPE and the sterilized cups were 3Mrad gamma-radiated in nitrogen. The surface roughness after wear test was unchanged for the roughened heads, while the initially smooth heads were slightly roughened. Preliminary results show that the rough heads increase the wear of the cups 2-fold. The gamma-irradiation affected both wear- and soak rate.

  • 8.
    Jedenmalm, Anneli
    et al.
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Murgia, G.
    Corrosion- and Metals Research Institute, Stockholm.
    Jacobson, K.
    Corrosion- and Metals Research Institute, Stockholm.
    Gedde, Ulf
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Effect of γ-irradiation sterilization in nitrogen on oxidation of hip-simulated UHMWPE cupsManuscript (preprint) (Other academic)
    Abstract [en]

    A hip simulator study with roughened heads revealed unexpected high wear rates for the γ-irradiated UHMWPE cups (sterilization performed in nitrogen) and also higher fluid absorbtion than that of the non-sterilized cups. Infrared spectroscopy and high-resolution scanning of samples stained with HCl and SO2 showed that the outer parts of cross-sections of the sterilized cups were oxidized after the wear testing. The non-sterilized cups showed essentially no polymer oxidation with only minor surface oxidation due to roughened head. The higher wear rate and the more extensive fluid absorption of the sterilized cups is thus attributed to oxidation of the polymer; the latter presumably being facilitated by the presence of long-living radicals generated during γ-irradiation sterilization.

  • 9.
    Jedenmalm, Anneli
    et al.
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology. Lund University, Sweden.
    Nilsson, Fritjof
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Noz, Marilyn E.
    New York University, Department of Radiology.
    Green, Douglas D.
    Loma Linda University, Orthopaedic Research Center.
    Gedde, Ulf W.
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Clarke, Ian C.
    Loma Linda University, Orthopaedic Research Center.
    Stark, Andreas
    Karolinska Institute, Department of Molecular Medicine and Surgery.
    Maguire Jr., Gerald Q.
    KTH, School of Information and Communication Technology (ICT), Communication Systems, CoS, Radio Systems Laboratory (RS Lab).
    Zeleznik, Michael P.
    Saya Systems Inc., Salt Lake City, UT, USA.
    Olivecrona, Henrik
    Karolinska Institute, Department of Molecular Medicine and Surgery.
    Validation of a 3D CT method for measurement of linear wear of acetabular cups: A hip simulator study2011In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 82, no 1, p. 35-41Article in journal (Refereed)
    Abstract [en]

    Material and methods Ultra-high molecular weight polyethylene cups with a titanium mesh molded on the outside were subjected to wear using a hip simulator. Before and after wear, they were (1) imaged with a CT scanner using a phantom model device, (2) measured using a coordinate measurement machine (CMM), and (3) weighed. CMM was used as the reference method for measurement of femoral head penetration into the cup and for comparison with CT, and gravimetric measurements were used as a reference for both CT and CMM. Femoral head penetration and wear vector angle were studied. The head diameters were also measured with both CMM and CT. The repeatability of the method proposed was evaluated with two repeated measurements using different positions of the phantom in the CT scanner. Results The accuracy of the 3D CT method for evaluation of linear wear was 0.51 mm and the repeatability was 0.39 mm. Repeatability for wear vector angle was 17 degrees A degrees. Interpretation This study of metal-meshed hip-simulated acetabular cups shows that CT has the capacity for reliable measurement of linear wear of acetabular cups at a clinically relevant level of accuracy.

  • 10.
    Jedenmalm, Anneli
    et al.
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Nilsson, Fritjof
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Noz, Marilyn
    Green, Douglas
    Gedde, Ulf
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Clarke, Ian
    Stark, Andreas
    Olivecrona, Henrik
    Validation of a 3D CT method for measuring linear and -volumetric wear of acetabular cups - a hip simulator studyIn: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682Article in journal (Other academic)
  • 11.
    Jedenmalm, Anneli
    et al.
    KTH, School of Chemical Science and Engineering (CHE), Fibre and Polymer Technology.
    Noz, Marilyn E.
    Department of Radiology, New York University School of Medicine, New York.
    Olivecrona, Henrik
    Department of Hand Surgery, Södersjukhuset, Stockholm.
    Olivecrona, Lofta
    Department of Radiology, Karolinska University Hospital Solna, Stockholm.
    Stark, Andre
    Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm.
    A new approach for assessment of wear in metal-backed acetabular cups using computed tomography: a phantom study with retrievals2008In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 79, no 2, p. 218-224Article in journal (Refereed)
    Abstract [en]

    Background and purpose Polyethylene wear is an important cause of aseptic loosening in hip arthroplasty. Detection of significant wear usually happens late on, since available diagnostic techniques are either not sensitive enough or too complicated and expensive for routine use. This study evaluates a new approach for measurement of linear wear of metal-backed acetabular cups using CT as the intended clinically feasible method.

    Material and methods 8 retrieved uncemented metal-backed acetabular cups were scanned twice ex vivo using CT. The linear penetration depth of the femoral head into the cup was measured in the CT volumes using dedicated software. Landmark points were placed on the CT images of cup and head, and also on a reference plane in order to calculate the wear vector magnitude and angle to one of the axes. A coordinate-measuring machine was used to test the accuracy of the proposed CT method. For this purpose, the head diameters were also measured by both methods.

    Results Accuracy of the CT method for linear wear measurements was 0.6 nm and wear vector angle was 27 degrees. No systematic difference was found between CT scans.

    Interpretation This study on explanted acetabular cups shows that CT is capable of reliable measurement of linear wear in acetabular cups at a clinically relevant level of accuracy. It was also possible to use the method for assessment of direction of wear.

  • 12.
    Olivecrona, Lotta
    et al.
    Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Radiology.
    Jedenmalm, Anneli
    KTH, School of Industrial Engineering and Management (ITM), Materials Science and Engineering.
    Aspelin, Peter
    Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Radiology.
    Weidenhielm, Lars
    Karolinska Institutet, Dept. Orthoped..
    Noz, Marilyn E.
    New York University, Department of Radiology.
    Maguire Jr., Gerald Q.
    KTH, School of Information and Communication Technology (ICT), Communication Systems, CoS.
    Zeleznik, Michael P.
    RAHD Oncology Products, St. Louis. Mo.
    Olivecrona, Henrik
    Department of Hand Surgery, Södersjukhuset, Stockholm.
    Assessing wear of the acetabular cup using computed tomography: an ex vivo study2005In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 46, no 8, p. 852-857Article in journal (Refereed)
    Abstract [en]

    Purpose: To validate a clinically useful method for measuring acetabular cup wear using computed tomography (CT). Material and Methods: Eight uncemented acetabular cups were scanned twice ex vivo using CT. The linear penetration depth of the femoral component head into the cup and the thickness of the remaining polyethylene liner were measured in the CT volumes using dedicated software. Two independent examiners twice assessed each volume. The CT measurements were compared to direct measurements using a coordinate measuring device and micrometer measurements. Results: Accuracy of wear measurements expressed as penetration depth was +/- 0.6 and +/- 1.0 mm for the two examiners, respectively, with no significant differences between examiners, trials, and CT scans. Accuracy of measurements of remaining polyethylene was +/- 1.3 and +/- 1.0 mm, respectively, for the two examiners. Systematic differences between examiners were found, but no significant differences between trials and CT scans. These differences were due to different interpretations of metal artifacts in the volumes. Conclusion: The proposed CT method for evaluating wear as head penetration depth allows for reliable wear detection at a clinically relevant level. Measurements of remaining polyethylene on CT volumes are not as reliable as wear measurements owing to metal artifacts.

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