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General Orthopaedics

PRECISION SURFACE MACHINING OF ARTIFICIAL JOINT BEARING SURFACES TO INHIBIT MACROPHAGE ACTIVATION

The International Society for Technology in Arthroplasty (ISTA), 27th Annual Congress. PART 3.



Abstract

This study presents the use of precision surface machining on artificial joint bearing surfaces in order to inhibit macrophage activation. Ultra-high molecular weight polyethylene (UHMWPE) is widely used as a bearing material in polymer-on-hard joint prostheses. However, UHMWPE wear particles are considered to be a major factor in long-term osteolysis and implant loosening. Several studies report that wear particle size is a critical factor in macrophage activation, with particles in the size range of 0.1 – 1.0 μm being the most biological active. The surface for a conventional Co-Cr-Mo alloy joint implant generally has a 10.0 – 20.0 nm roughness. After precision machining, the Co-Cr-Mo alloy surface had a 1.0 – 2.0 nm roughness with scattered concave shapes up to 50 nm in depth. This precision surface machining method used a typical lapping method, but the relationship between the slurry and the machining surface was strictly controlled in order to emphasize the micro-erosion mechanism. A pin-on-disc wear tester capable of multidirectional motion was used to verify that the new surface was the most appropriate for joints. Tests were carried out in 25% (v/v) fetal calf serum with sodium azide to retard bacterial growth. UHMWPE pins, 12.0 mm in diameter with a mean molecular weight of 6.0 million, were placed on the Co-Cr-Mo alloy disc at a contact pressure of 6.0 MPa. A sliding speed of 12.1 mm/s, and a total sliding distance of 15.0 km were applied. The new surface reduced the amount of UHMWPE wear, which would ensure the long-term durability of joints. The new surface also enlarged the size of UHMWPE particles, but did not change their morphological aspect. Primary human peripheral blood mononuclear phagocytes were cultured with the particles. The wear particles generated on the new surface inhibited the production of IL-6, which indicates a reduction of induced tissue reaction and joint loosening.


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