Measurement method of in vitro friction and wear of artificial ligaments

HUANG Xiuling; ZHENG Ye; LAI Weiguo; ZHU Junjun; HUA Zikai

doi:10.16511/j.cnki.qhdxxb.2024.26.005

PDF(17328 KB)

Journal of Tsinghua University(Science and Technology) ›› 2024, Vol. 64 ›› Issue (3) : 432-441. DOI: 10.16511/j.cnki.qhdxxb.2024.26.005

FRONTIERS IN BIOTRIBOLOGY

Measurement method of in vitro friction and wear of artificial ligaments

{{article.zuoZhe_EN}}

Author information +

History +

Abstract

[Objective] Artificial ligaments are crucial implants in ligament reconstruction surgery, and in clinical practice, adverse events such as fracture and failure of artificial ligaments are commonly observed because of friction and wear. The wear of artificial ligaments not only weakens the performance of the prosthesis but also potentially causes iatrogenic arthropathy. Therefore, investigating the friction and wear performance of artificial ligaments in vitro is important. Currently, neither domestic nor international standards have specified methods for measuring the wear of artificial ligaments. Furthermore, quantitative research methods for studying friction and wear are limited; moreover, only a few studies have been conducted on the methods for assessing the wear of artificial ligaments. [Methods] In this study, artificial ligaments were subjected to 2.0×10⁶ cycles in the in vitro friction wear test following the YY/T 0965—2014 standard. Subsequently, three wear test groups were established in accordance with the YY/T 1426.1—2016 standard. A loading control group was also established simultaneously to mitigate the weight errors caused by ligament water absorption. Artificial ligaments were periodically cleaned and weighed in accordance with the YY/T 1426.2—2016. Furthermore, the gravimetric method was employed to measure and analyze the amount of wear on the artificial ligaments. The micromorphology of the artificial ligaments after wear was observed using a stereoscopic microscope, and the wear debris generated by abrasion in 1.5×10⁶—2.0×10⁶ wear cycles was extracted and sent to a scanning electron microscope for observation. The wear debris was characterized according to ASTM F1877-16. [Results] In the three test groups, the amount of wear of the artificial ligaments increased linearly, with an average wear rate of (6.94 ±2.30)mg/10⁶ cycles. After abrading the artificial ligaments, some surface tissues appeared rough, and the braided structure was damaged. The filament sorting was loose and fractured, similar to the failed ligaments removed in the clinic. Additionally, the wear process of artificial ligaments produced white and opaque wear debris, mainly consisting of irregular particles ranging from nanometer to micrometer sizes. Most of the extracted wear debris appeared as spheres, and only a small portion was in the form of fibrous strips. The majority of the wear debris was small, whereas only a little of them was large. Most of the extracted wear debris was spherical, whereas a little was in the form of fibrous strips. There were more small-sized and fewer large-sized wear debris, which were relatively less biologically active and had a lower risk of triggering joint diseases. The results of this study provided a strong reference for refining the standards for in vitro friction wear test of artificial ligaments. [Conclusions] The wear rates of artificial ligaments are comparable to that of hip and knee prostheses reported in some studies. This should not be overlooked, as its biotribological behavior directly affects the outcomes of replacement surgery. Therefore, establishing scientific and rational in vitro wear measurements and wear debris analysis has great scientific value and significance in accurately predicting the clinical wear of artificial ligaments.

Key words

artificial ligaments / friction and wear / measurement method / wear debris isolation and extraction

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

HUANG Xiuling, ZHENG Ye, LAI Weiguo, ZHU Junjun, HUA Zikai. Measurement method of in vitro friction and wear of artificial ligaments[J]. Journal of Tsinghua University(Science and Technology). 2024, 64(3): 432-441 https://doi.org/10.16511/j.cnki.qhdxxb.2024.26.005

References

[1] 王圣昊, 何耀华. 前交叉韧带修复技术研究进展[J]. 国际骨科学杂志, 2023, 44(4):203-206. WANG S H, HE Y H. Research progress on the repair technique of anterior cruciate ligament[J]. International Journal of Orthopaedics, 2023, 44(4):203-206. (in Chinese)
[2] 史简铭. 自体韧带和人工韧带治疗交叉韧带损伤的疗效对比[D]. 郑州:郑州大学, 2021. SHI J M. Comparative study on the effect of autogenous ligament and artificial ligament in the treatment of cruciate ligament injury[D]. Zhengzhou:Zhengzhou University, 2021. (in Chinese)
[3] SCHILATY N D, BATES N A, NAGELLI C V, et al. Sex-based differences of medial collateral ligament and anterior cruciate ligament strains with cadaveric impact simulations[J]. Orthopaedic Journal of Sports Medicine, 2018, 6(4):2325967118765215.
[4] 赵旭辉, 王芳. 人工韧带材料表面修饰及在膝关节交叉韧带重建中的应用[J]. 中国组织工程研究与临床康复, 2010, 14(42):7915-7918. ZHAO X H, WANG F. Surface modification of artificial ligaments and their application in knee cruciate ligament reconstruction[J]. Journal of Clinical Rehabilitative Tissue Engineering Research, 2010, 14(42):7915-7918. (in Chinese)
[5] 万超, 郝智秀, 温诗铸, 等. 前交叉韧带移植物种类及拉力影响的有限元模拟[J]. 清华大学学报(自然科学版), 2014, 54(10):1282-1287. WAN C, HAO Z X, WEN S Z, et al. Three-dimensional finite element simulations of the long-term effects of hamstring tendon graft type and tensioning on anterior cruciate ligament reconstruction[J]. Journal of Tsinghua University (Science & Technology), 2014, 54(10):1282-1287. (in Chinese)
[6] 关国平, 关红涛, 王璐. 韧带损伤及人工韧带应用与研究[J]. 生物医学工程学进展, 2013, 34(4):234-238. GUAN G P, GUAN H T, WANG L. Ligament injury and application and research of artificial ligaments[J]. Progress in Biomedical Engineering, 2013, 34(4):234-238. (in Chinese)
[7] 李君芳. 人工韧带重建与膝关节前交叉韧带的运动损伤[J]. 中国组织工程研究与临床康复, 2010, 14(12):2221-2224. LI J F. Artificial ligament reconstruction and movement injury to anterior cruciate ligament of the knee joint[J]. Chinese Journal of Tissue Engineering Research, 2010, 14(12):2221-2224. (in Chinese)
[8] JIANG H, SHANG X, WU H T, et al. Resveratrol downregulates PI3K/Akt/mTOR signaling pathways in human U251 glioma cells[J]. Journal of Experimental Therapeutics and Oncology, 2009, 8(1):25-33.
[9] 陈天午, 陈世益. 人工韧带用于前交叉韧带修复重建:目前产品与经验[J]. 中国修复重建外科杂志, 2020, 34(1):1-9. CHEN T W, CHEN S Y. Artificial ligaments applied in anterior cruciate ligament repair and reconstruction:Current products and experience[J]. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(1):1-9. (in Chinese)
[10] 陈世益, 陈天午. 采用新一代人工韧带重建前十字韧带的关键技术和不良事件:基于改良Delphi法制订的中国专家共识(二)[J]. 中国修复重建外科杂志, 2022, 36(9):1047-1055. CHEN S Y, CHEN T W. Core techniques and adverse events in anterior cruciate ligament reconstruction using a new generation of artificial ligaments:The consensus of Chinese specialists based on a modified Delphi method (Part 2)[J]. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(9):1047-1055. (in Chinese)
[11] 袁拥军, 何国础, 岑建平, 等. 先进人工韧带加强系统人工韧带与自体骨-髌腱-骨重建膝前交叉韧带的早期临床疗效比较[J]. 上海医学, 2009, 32(7):598-601. YUAN Y J, HE G C, CEN J P, et al. Anterior cruciate ligament reconstruction with ligament advanced reinforcement system artificial ligament and autogenous bone-patellar tendon-bone:A comparison of early clinical outcomes[J]. Shanghai Medical Journal, 2009, 32(7):598-601. (in Chinese)
[12] YAHIA L. Ligaments and ligamentoplasties[M]. Heidelberg:Springer, 1997.
[13] GUIDOIN M F, MAROIS Y, BEJUI J, et al. Analysis of retrieved polymer fiber based replacements for the ACL[J]. Biomaterials, 2000, 21(23):2461-2474.
[14] OLSON E J, KANG J D, FU F H, et al. The biochemical and histological effects of artificial ligament wear particles:In vitro and in vivo studies[J]. The American Journal of Sports Medicine, 1988, 16(6):558-570.
[15] VIATEAU V, MANASSERO M, ANAGNOSTOU F, et al. Biological and biomechanical evaluation of the ligament advanced reinforcement system (LARS AC) in a sheep model of anterior cruciate ligament replacement:A 3-month and 12-month study[J]. Arthroscopy:The Journal of Arthroscopic and Related Surgery, 2013, 29(6):1079-1088.
[16] GLEZOS C M, WALLER A, BOURKE H E, et al. Disabling synovitis associated with LARS artificial ligament use in anterior cruciate ligament reconstruction[J]. The American Journal of Sports Medicine, 2012, 40(5):1167-1171.
[17] 国家食品药品监督管理总局. 无源外科植入物人工韧带专用要求:YY/T 0965-2014[S]. 北京:中国标准出版社, 2014. China Food and Drug Administration. Implants for surgery:Artificial ligaments:YY/T 0965-2014[S]. Beijing:Standards Press of China, 2014. (in Chinese)
[18]国家食品药品监督管理总局. 外科植入物全膝关节假体的磨损第1部分:载荷控制的磨损试验机的载荷和位移参数及相关的试验环境条件:YY/T 1426.1-2016[S]. 北京:中国标准出版社, 2016. China Food and Drug Administration. Implants for surgery-Wear of total knee-joint prostheses-Part 1:Loading and displacement parameters for wear-testing machines with load control and corresponding environmental conditions for test:YY/T 1426.1-2016[S]. Beijing:Standards Press of China, 2016. (in Chinese)
[19]国家食品药品监督管理总局. 外科植入物全膝关节假体的磨损第2部分:测量方法:YY/T 1426.2-2016[S]. 北京:中国标准出版社, 2016. China Food and Drug Administration. Implants for surgery-Wear of total knee-joint prostheses-Part 2:Methods of measurement:YY/T 1426.2-2016[S]. Beijing:Standards Press of China, 2016. (in Chinese)
[20] American Society for Testing and Materials. Standard practice for characterization of particles:ASTM F1877-16[S]. West Conshohocken:American Society for Testing and Materials,2016.
[21] VISENTIN M, STEA S, SQUARZONI S, et al. Isolation and characterization of wear debris generated in patients wearing polyethylene hylamer inserts, Gamma irradiated in air[J]. Journal of Biomaterials Applications, 2005, 20(2):103-121.
[22] GRUPP T M, FRITZ B, KUTZNER I, et al. Vitamin E stabilised polyethylene for total knee arthroplasty evaluated under highly demanding activities wear simulation[J]. Acta Biomaterialia, 2017, 48:415-422.
[23] AFFATATO S, RUGGIERO A, JABER S A, et al. Wear behaviours and oxidation effects on different UHMWPE acetabular cups using a hip joint simulator[J]. Materials, 2018, 11(3):433.
[24] FALOTICO G G, TAKATA P, JACOB L S, et al. Comparative biomechanical study of crosslinked polyethylene wear with 36-mm ceramic femoral heads and with 32-mm metal femoral heads[J]. Revista Brasileira de Ortopedia, 2020, 55(5):597-604.
[25] 张洪玉, 蒋向前, BLUNT L, 等. 人工髋关节柄磨损评定中的三维表面形貌测量[J]. 应用基础与工程科学学报, 2012, 20(1):139-148. ZHANG H Y, JIANG X Q, BLUNT L, et al. The application of 3-D surface metrology in characterization of femoral stem wear[J]. Journal of Basic Science and Engineering, 2012, 20(1):139-148. (in Chinese)
[26] BAHÇE E, EMIR E. Wear and validation of posterior stabilized knee prosthesis with the knee simulator[J]. Materials Technology, 2021, 36(6):356-363.
[27] YANG S Y, REN W P, PARK Y, et al. Diverse cellular and apoptotic responses to variant shapes of UHMWPE particles in a murine model of inflammation[J]. Biomaterials, 2002, 23(17):3535-3543.
[28] GREEN T R, FISHER J, STONE M, et al. Polyethylene particles of a 'critical size' are necessary for the induction of cytokines by macrophages in vitro[J]. Biomaterials, 1998, 19(24):2297-2302.
[29] BOLTON C W, BRUCHMAN W C. The GORE-TEX expanded polytetrafluoroethylene prosthetic ligament. An in vitro and in vivo evaluation[J]. Clinical Orthopaedics and Related Research, 1985(196):202-213.
[30] 陈天午, 陈世益. 走出人工韧带重建前交叉韧带的历史误区:总结中国成功经验[J]. 中国医学前沿杂志(电子版), 2020, 12(9):1-7. CHEN T W, CHEN S Y. Walk out of the historical misunderstanding of artificial ligament used for anterior cruciate ligament reconstruction:Sum up China's successful experience[J]. Chinese Journal of the Frontiers of Medical Science (Electronic Version), 2020, 12(9):1-7. (in Chinese)