Готові списки джерел за темами / Acetabular liner

Добірка наукової літератури з теми "Acetabular liner"

Автор: Grafiati

Опубліковано: 6 вересня 2023

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Статті в журналах з теми "Acetabular liner"

Yeroushalmi, David, Katherine A. Lygrisse, Mohamad Sharan, Nolan A. Maher, Joseph D. Zuckerman, and Ran Schwarzkopf. "Mid- to Long-Term Survivorship Analysis of a Second-Generation Highly Cross-Linked Polyethylene in Total Hip Arthroplasty." Journal of Hip Surgery 4, no. 03 (July 20, 2020): 124–28. http://dx.doi.org/10.1055/s-0040-1714292.

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AbstractThe emergence of highly cross-linked polyethylene (HCLPE) has drastically improved survivorship of implants used in total hip arthroplasty (THA), as demonstrated by midterm outcomes. However, there is limited data evaluating long-term outcomes and wear rates of these liners. Therefore, the aim of this study is to evaluate the longest-to-date follow-up of a specific second-generation HCLPE liner, the progression of wear rate, and its relation to acetabular cup positioning. A retrospective study was conducted on patients who underwent THA between January 2001 and December 2005 using a specific second-generation HCLPE liner. Annual liner wear rate (mm/year) was calculated in this group as well as acetabular positioning through abduction angle (degrees). Failures and reason for failures such as periprosthetic fracture, dislocation, and osteolysis were noted when applicable. Forty hips of 35 patients were included in this study with a clinical and radiographic follow-up of 13.4 ± 2.2 years (range: 10.0–16.7 years). Linear and volumetric wear rates were calculated to be 0.037 ± 0.020 mm/year and 22.94 ± 12.07 mm3/year, respectively. No radiographic femoral or acetabular osteolysis was observed in any of the cases. One patient required revision due to complications unrelated to the liner. No significant relationship could be established for acetabular component abduction angle and linear wear rate (p = 0.690, Spearman's rho = 0.03). Our study demonstrates comparable liner wear rates to that of other second-generation HCLPE liners in long-term follow-up. The XLPE liner continues to exhibit minimal progression of linear wear when compared with previous midterm studies and maintains a low rate of postoperative complications requiring revision THA surgery. Further studies are warranted to assess long-term wear and survivorship between this specific liner and comparable HCLPE models.

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Napier, Richard J., Owen Diamond, Chris K. J. O'Neill, Seamus O'Brien, and David E. Beverland. "The Incidence of Dissociated Liners in 4,751 Consecutive Total Hip Arthroplasties Using Pinnacle Polyethylene Acetabular Liners." HIP International 27, no. 6 (June 14, 2017): 537–45. http://dx.doi.org/10.5301/hipint.5000512.

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Introduction Acetabular liner dissociation is a complication exclusive to modular designs. We present a single surgeon series of 8 polyethylene liner dissociations with the Pinnacle Acetabular System (DePuy Orthopaedics) from over 4,750 cases. We also present a review of the literature and data from the UK National Joint Registry (NJR) on dissociation in total hip arthroplasty (THA). Methods The Pinnacle Acetabular System has been used exclusively by the senior author since April 2003, and to date 5,882 have been implanted (837 ceramic liners, 4,751 polyethylene liners (1,606 Enduron/3,145 Marathon) and 294 metal liners). We reviewed all cases of liner dissociation from this cohort to determine an overall incidence with polyethylene liners, identify associated risk factors, and report the outcome following revision surgery. Results Our incidence of this complication is 8 out of 4,751 cases (0.17%). Review of these cases and the literature suggests that femoral neck impingement against the polyethylene liner and/or edge loading may produce fatigue failure of the locking mechanism and subsequent dissociation. Conclusions Ensuring correct liner seating/locking, minimising impingement, achieving appropriate component version and avoiding radiographic cup inclinations >50° should minimise the risk of liner dissociation. Any new noise or squeaking from a polyethylene liner should undergo radiographic investigation to exclude dissociation. We recommend managing late cases of liner dissociation with revision of the acetabular shell if the cup orientation could be improved or if there is any damage to the liner-locking groove, to reduce the risk of recurrence.

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Lombardi, Adolph V., and Keith R. Berend. "Isolated Acetabular Liner Exchange." Journal of the American Academy of Orthopaedic Surgeons 16, no. 5 (May 2008): 243–48. http://dx.doi.org/10.5435/00124635-200805000-00002.

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Keggi, John M., Robert E. Kennon, Lee E. Rubin, and Kristaps J. Keggi. "Isolated Acetabular Liner Exchange." Journal of the American Academy of Orthopaedic Surgeons 16, no. 8 (August 2008): 495. http://dx.doi.org/10.5435/00124635-200808000-00009.

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Lombardi, Adolph V. "Isolated Acetabular Liner Exchange." Journal of the American Academy of Orthopaedic Surgeons 16, no. 8 (August 2008): 496. http://dx.doi.org/10.5435/00124635-200808000-00010.

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Keggi, John M., Robert E. Kennon, Lee E. Rubin, Kristaps J. Keggi, and Adolph V. Lombardi. "Isolated Acetabular Liner Exchange." Journal of the American Academy of Orthopaedic Surgeons 16, no. 9 (September 2008): 495–96. http://dx.doi.org/10.5435/00124635-200809000-00001.

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Ismail, Rifky, Sugiyanto Sugiyanto, Henry Kristianto, Eko Saputra, and Jamari Jamari. "Pemodelan Metode Elemen Hingga Kontak Femoral Head dengan Acetabular Liner pada Sendi Panggul Buatan dengan Variasi Diameter Celah pada Acetabular Liner." ROTASI 19, no. 3 (September 16, 2017): 139. http://dx.doi.org/10.14710/rotasi.19.3.139-146.

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Sendi panggul buatan (artificial hip joint) memiliki beberapa komponen utama, yaitu stem, femoral head dan acetabular shell yang terbuat dari material logam dan acetabular liner yang terbuat dari komponen polimer dengan jenis UHWMPE (ultra-high-molecular-weight polyethylene). Pada desain sendi panggul buatan, yang diproduksi oleh UNDIP terdapat alternatif desain permesinan komponen acetabular liner yang memiliki celah pada titik pusat acetabular liner-nya. Untuk menguji alternatif desain ini, perlu dilakukan penelitian untuk mengetahui efek dari celah yang terdapat pada pusat acetabular liner terhadap distribusi contact pressure dan tegangan von Mises. Penelitian ini dilakukan dengan tujuan mengetahui pengaruh dari variasi diameter celah yang terdapat pada acetabular liner sendi panggul buatan produk UNDIP terhadap tekanan kontak dan tegangan von Mises. Penelitian dilakukan menggunakan metode elemen hingga dengan software ABAQUS. Femoral head dimodelkan menggunakan material stainless steel AISI 316L dan acetabular liner dimodelkan menggunakan material UHMWPE. Beban yang diberikan pada kontak femoral head dan acetabular liner ini dimodelkan sebesar 5 N menuju titik pusat acetabular liner dengan variasi diameter celah: 0,5 mm, 1 mm, 1,5 mm, 2 mm, 2,5 mm dan 3 mm.. Jumlah elemen yang digunakan sebanyak 9000 buah setelah dikonfirmasi validitas penentuan mesh. Hasil simulasi menunjukkan bahwa terdapat konsentrasi tegangan pada tepi celah yang ditandai dengan tinggiya contact pressure dan tegangan von Mises. Nilai tertinggi kedua luaran ini terlihat pada diameter celah sebesar 2 mm yang nilai maksimumnya mencapai 4 kali dari besar contact pressure dan tegangan von Mises pada diameter celah yang lain. Fenomena ini diperkirakan disebabkan karena tepi dari celah berimpit dengan tepi dari jari-jari kontak yang terbentuk pada sistem kontak mekanik femoral head dan acetabular liner. Adanya kenaikan yang dramatis ini dapat mengakibatkan naiknya keausan (wear) dan munculnya kemungkinan terjadinya deformasi plastis yang lebih besar pada liner. Rekomendasi yang diberikan pada pemberian celah ini adalah sebaiknya dihindari untuk mengurangi terjadinya wear dan deformasi plastis yang terlalu besar. Dalam kondisi celah tidak dapat dihindari maka diameter celah tidak lebih dari 14% dari diameter femoral head

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Andersen, Annette Vest, Anne Grete Kjersgaard, and Søren Solgaard. "Trilogy-Constrained Acetabular Component for Recurrent Dislocation." ISRN Orthopedics 2013 (January 10, 2013): 1–4. http://dx.doi.org/10.1155/2013/629201.

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32 patients received a Trilogy- or Trilogy-Longevity-constrained acetabular liner for recurrent dislocations after total hip replacement. The constrained liner was inserted into a well-fixed Trilogy acetabular shell with snap fit. At 1.8-year followup (range 3–63 months), 4 patients had suffered further dislocation(s) (12%), and one patient had revision surgery for a loosened acetabular shell. Radiologic evaluation detected no definitively loose components, but one patient with progressing radiolucent lines around the femoral component and one patient with an acetabular cyst were found, as well as a patient with a loose locking ring (but otherwise no failure). The nineteen patients who were available for the present followup had a mean Harris Hip Score of 81. The constrained liner is an effective method of dealing with recurrent dislocations in well-fixed components.

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Jiranek, William A. "Acetabular Liner Fixation by Cement." Clinical Orthopaedics & Related Research 417 (December 2003): 217–23. http://dx.doi.org/10.1097/01.blo.0000096805.78689.8b.

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Parkar, Asif A. H., Mohamed Sukeik, Ahmed El-Bakoury, and James Powell. "Acetabular liner dissociation: A case report and review of the literature." SICOT-J 5 (2019): 31. http://dx.doi.org/10.1051/sicotj/2019025.

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Dissociation of the polyethylene liner from the acetabular shell is a rare but catastrophic complication of total hip arthroplasty (THA). There have been reports of polyethylene liner dissociation (PLD) as well as ceramic liner dissociation (CLD) in the literature. Amongst the commonly used implants, liner dissociation has been reported with the Pinnacle (DePuy), Harris–Galante (Zimmer) and Trident (Stryker) acetabular components. To the best of our knowledge, this is the first case report of PLD in an R3 (Smith & Nephew) acetabular component. This case report highlights the implant choice for treatment of the liner dissociation and the role of constrained implants in such cases.

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Дисертації з теми "Acetabular liner"

Vidushi. "Development of novel bionanocomposites for musculoskeletal reconstruction applications." Thesis, 2021. https://etd.iisc.ac.in/handle/2005/5730.

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With an increase in the aging population worldwide, a surge in demand for joint replacement has been observed. It has been anticipated that by 2030, the demand for primary total hip joint replacement (THR) will increase by 171% for patients less than 65 years of age. Although THR is considered to be the most efficacious surgical intervention in load-bearing orthopedic applications, its overall success is constrained by unavoidable clinical issues such as osteolysis and aseptic loosening resulting in implant failure. In this context, Ultra-high molecular weight polyethylene (UHMWPE) has been playing a significant role as an acetabular liner over the last six decades due to its attractive mechano-chemical, tribological, and biocompatibility properties. Yet, the challenges posed by UHMWPE, particularly those associated with its in vivo wear and oxidation, need to be addressed. A substantial part of this dissertation will explore the science behind the processibility, physicomechanical properties, and biocompatibility of the new generation modified graphene oxide reinforced HDPE/UHMWPE (HUmGO) nanocomposite for acetabular liner applications. Overall, the HUmGO proved to be a promising biomaterial when benchmarked against commercially available medical-grade UHMWPE and XL-UHMWPE and also with Trident®X3® (Stryker, orthopedics) implant in terms of the manufacturing, following dimensions, and properties. On the other hand, another aspect to be considered for THR success is the physical interlocking between the reamed acetabulum and the metal-backed (especially Ti-6Al-4V) acetabular assembly. The bioinertness of the Ti-6Al-4V-backed acetabular shell interferes with implant-bone bonding; hence, a bioactive material-coated acetabular shell is used. Even though hydroxyapatite (HA)-coated Ti-6Al-4V shells are used in clinical settings, due to cell-mediated resorption and lack of suitable properties, there is a constant need to introduce stable and adherent new generation coating material for bioinert Ti-6Al-4V acetabular shell. This dissertation will also discuss the deposition of an adherent pDOPA co-doped Barium Titanium reinforced (BT) functionalized PVDF nanocomposite coating on Ti-6Al-4V with desired physicochemical and cytocompatibility properties for acetabular shell applications concerning better osseointegration. Herein, the fundamental aspects of cell-material interactions have been correlated with the substrate functionalities. Taken together, our observations indicate that osteoblast functionality can be tailored by providing a cell-instructive surface modification to the acetabular components. Summarizing, this dissertation will broadly revolve around the development of novel for the acetabular components with the view to eliminate long-standing clinical issues of osteolysis and aseptic loosening, resulting in a shorter implant lifespan. On fundamental aspects, this dissertation will also provide qualitative and quantitative insights into the process-structure-properties of these new generation bionanocomposites.
Department of Biotechnology-Centre of Excellence through ‘Programme support on translational research on biomaterials for orthopedic and dental applications’ (No. BT/PR13466/COE/34/26/2015), Science and Engineering Research Board (SERB)-Department of Science and Technology (DST)-IMPRINT (IMP/2018/000622), Govt. of India

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Частини книг з теми "Acetabular liner"

Frye, Benjamin M., and Keith R. Berend. "Minimally Invasive Direct Anterior Approach for Acetabular Liner Revision." In Minimally Invasive Surgery in Orthopedics, 1–13. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-15206-6_49-1.

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Frye, Benjamin M., and Keith R. Berend. "Minimally Invasive Direct Anterior Approach for Acetabular Liner Revision." In Minimally Invasive Surgery in Orthopedics, 553–65. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-34109-5_49.

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Cho, Changhee, Toshiharu Mori, and Makoto Kawasaki. "Finite Element Simulations for Investigating the Cause of Catastrophic Wear and/or Failure of Polyethylene Acetabular Cup Liner in Hip Prosthesis." In Lecture Notes in Computational Vision and Biomechanics, 539–49. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-43195-2_44.

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Smolin, Alexey Yu, Galina M. Eremina, and Evgeny V. Shilko. "A Tool for Studying the Mechanical Behavior of the Bone–Endoprosthesis System Based on Multi-scale Simulation." In Springer Tracts in Mechanical Engineering, 91–126. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-60124-9_5.

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AbstractThe chapter presents recent advances in developing numerical models for multiscale simulation of the femur–endoprosthesis system for the case of hip resurfacing arthroplasty. The models are based on the movable cellular automaton method, which is a representative of the discrete element approach in solid mechanics and allows correctly simulating mechanical behavior of a variety of elastoplastic materials including fracture and mass mixing. At the lowest scale, the model describes sliding friction between two rough surfaces of TiN coatings, which correspond to different parts of the friction pair of hip resurfacing endoprosthesis. At this scale, such parameters of the contacting surfaces as the thickness, roughness, and mechanical properties are considered explicitly. The next scale of the model corresponds to a resurfacing cap for the femur head rotating in the artificial acetabulum insert. Here, sliding friction is explicitly computed based on the effective coefficient of friction obtained at the previous scale. At the macroscale, the proximal part of the femur with a resurfacing cap is simulated at different loads. The bone is considered as a composite consisting of outer cortical and inner cancellous tissues, which are simulated within two approaches: the first implies their linear elastic behavior, the second considers these tissues as Boit’s poroelastic bodies. The later allows revealing the role of the interstitial biological fluid in the mechanical behavior of the bone. Based on the analysis of the obtained results, the plan for future works is proposed.

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Тези доповідей конференцій з теми "Acetabular liner"

Fang, Zhibin, Barbara J. Kralovic, Yang W. Son, Danny L. Levine, and Todd S. Johnson. "A Mutlti-Scale FE Modeling Approach to Investigate the Contact Mechanics and Interfacial Stress of a Low Stiffness Porous Metal-Backed Acetabular Cup." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-192956.

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In modern Total Hip Arthroplasty (THA), modular metal-backed acetabular cups consisting of a metal shell backing with porous coatings for fixation and a modular polyethylene liner for articulation are currently the most widely used cementless acetabular cups. Modular acetabular cups give surgeons the flexibility to change femoral head size, liner offset, and liner-lip buildup during hip arthroplasty as well as the ability to change the liner without removing a bone-ingrowth metal shell during revision surgery. However, concerns have been noted with modular metal backed acetabular cups. Poor locking mechanisms have been blamed for backside wear and polyethylene liner dislodgement as well as debris which may lead to osteolysis [1]. In addition, the study of the load transfer around acetabular cups has shown that a stiff metal backing generates high stress peaks around the acetabular rim while it reduces the stresses transferred at the central part of acetabulum potentially causing stress shielding at the dome of acetabulum [2].

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Saputra, Eko, Iwan Budiwan Anwar, Rifky Ismail, J. Jamari, and Emile van der Heide. "Finite element analysis of the impingement on the acetabular liner rim due to wear of the acetabular liner surface." In THE 3RD INTERNATIONAL CONFERENCE ON ADVANCED MATERIALS SCIENCE AND TECHNOLOGY (ICAMST 2015). Author(s), 2016. http://dx.doi.org/10.1063/1.4945528.

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Kurtz, Steven M., Jorge A. Ochoa, and Christopher V. White. "Liner/Shell Load Transfer Mechanisms in a Modular Acetabular Component for Total Hip Replacement." In ASME 1997 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1997. http://dx.doi.org/10.1115/imece1997-0349.

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Abstract Modular acetabular components have seen widespread clinical use since the 1980’s (Collier et al., 1992). However, nonconformity between the polyethylene liner and the metal shell may exist in modular acetabular components by design, due to limitations on polyethylene liner manufacturing tolerances, or from the incorporation of locking mechanisms to attach the liner to the shell. Previous research has demonstrated that the stresses at the articulating surface are sensitive to nonconformity between the liner and the metal shell (Kurtz et al., 1994). Deleterious rim loading may also occur in a rimmed polyethylene liner with radial interference between the liner and the metal shell (Kurtz et al., 1993).

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Chi, Wei-Min, Chien-Chung Lin, Chih-Wei Lin, Hsiao-Che Lin, and Jian-Horng Chen. "Finite Element Analysis of Mechanical Effects of Lip Radii on Three Types of Acetabular Liner Rim after Prosthetic Impingement." In 2018 1st IEEE International Conference on Knowledge Innovation and Invention (ICKII). IEEE, 2018. http://dx.doi.org/10.1109/ickii.2018.8569116.

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Soemardi, Tresna P., Agri Suwandi, and Anwar Soefi Ibrahim. "Simulation Experiment to Predict the Critical Friction Area of Acetabular Liner Component on Hip Joint Replacement Implant During Movement." In 2nd Borobudur International Symposium on Science and Technology (BIS-STE 2020). Paris, France: Atlantis Press, 2021. http://dx.doi.org/10.2991/aer.k.210810.026.

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Chi, Wei Min, Chien-Chung Lin, Chih-Wei Lin, Hsiao-Che Lin, and Jian-Horng Chen. "Finite Element Analysis on Dislocation Torque and Contact Stress of a Novel Acetabular Cup Liner Defect When Prosthetic Impingement Occurs." In 2018 1st IEEE International Conference on Knowledge Innovation and Invention (ICKII). IEEE, 2018. http://dx.doi.org/10.1109/ickii.2018.8569179.

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Karuppiah, K. S. Kanaga, Sriram Sundararajan, Zhi-Hui Xu, and Xiaodong Li. "The Effect of Surface Processing on the Protein Adsorption and Tribomechanical Properties of Ultra-High-Molecular Weight Polyethylene." In ASME 2006 International Mechanical Engineering Congress and Exposition. ASMEDC, 2006. http://dx.doi.org/10.1115/imece2006-15187.

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Ultra-high molecular weight polyethylene (UHMWPE) is a popular choice for the liner material of the acetabular cup and forms one of the articulating surfaces in total joint replacements (TJRs). Evaluating the tribological characteristics of UHMWPE on immediate contact with the physiological fluid is essential to understand pathways and mechanisms of eventual failure. In this study, the friction response and interfacial shear strength of a UHMWPE - ceramic interface was quantified using atomic force microscopy (AFM) before and after exposure to bovine serum albumin (BSA) solution. A 10% protein solution concentration was used to closely mimic protein levels in human physiological fluid. Medical grade UHMWPE samples with two different surface finishing treatments, milling and melting/reforming were used in the experiments. Friction response as a function of normal load was monitored on a particular area on each sample. Fluorescence microscopy was used to assess the protein adsorption on the test area. The interfacial shear strength of the interface was calculated from the friction data using contact mechanics. Contact angle measurements were also performed on the surfaces to evaluate the surface energies before and after protein adsorption. Correlations between the friction behavior and surface energy of the surfaces are discussed.

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Damien, Pascal, Ralph Bou Nader, Charles Yaacoub, and Jean-Claude Lahoud. "Iliopectineal Line Fracture Detection for Computer-Aided Acetabular Fracture Classification." In 2019 Ninth International Conference on Image Processing Theory, Tools and Applications (IPTA). IEEE, 2019. http://dx.doi.org/10.1109/ipta.2019.8936080.

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Muhlstein, C. L., S. M. Kurtz, C. Chui, M. Rising, and A. A. Edidin. "The Relationship Between Hip Simulator Wear and Surface Morphology Characterized Using White Light Interferometry." In ASME 1999 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1999. http://dx.doi.org/10.1115/imece1999-0421.

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Abstract A non-contact surface topography measurement system based on white light interferometry was used to quantify the surface morphology of the UHMWPE, PTFE, HDPE, and polyacetal liners before and after wear testing. We investigated the hypothesis that the wear rate of four polymeric materials in the hip simulator was related to quantitative metrics of the surface morphology (i.e., surface roughness). Nine common roughness parameters (PV, Ra, Rrms, Rsk, Rku, Rtm, Rz, R3z, and H) were evaluated in 28 acetabular liners. The surface morphology within a given material was reproducible from insert to insert. Statistical relationships were observed between the surface roughness of the acetabular liners and the volumetric wear rate (p < 1 × 10−6). However, the power law relationships accounted for less than 50% of the variability in the data, based on r2.

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Untaroiu, Costin D., Robert S. Salzar, Herve´ Guillemot, and Jeff R. Crandall. "The Strain Distribution and Force Transmission Path Through Pubic Rami During Lateral Pelvic Impacts." In ASME 2008 International Mechanical Engineering Congress and Exposition. ASMEDC, 2008. http://dx.doi.org/10.1115/imece2008-67791.

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The pubic rami fracture is a common pelvic injury for vehicle occupants as well as for pedestrians struck during side impacts. While many studies have investigated the structural properties of the pelvis in lateral loading, relatively few investigations have compared the applied loads with local response of the pubic rami. The aims of this study are to investigate the force transmission paths and strain distribution for the anterior (i.e., rami) and posterior (i.e., sacrum) regions of the pelvis under acetabular impact loading. Eight male postmortem human surrogate pelves were tested to failure in quasi-static (n = 2) and dynamic (n = 6) conditions using an Instron test machine and a drop-tower, respectively. The denuded pelves were potted and then cut along a line connecting the greater sciatic notch and the middle of anterior iliac spine. Lateral loading was applied at the site of the acetabulum using a custom-fit femoral head surrogate made of steel. An acoustic emission (AE) sensor and uniaxial strain gages were affixed to the four rami (anterior and posterior) to assess the time of fracture as well as the regional strain distribution. In addition to measuring the impacting force, the loads transmitted through the pelvis were recorded on the non-struck side using load cells at the inferior and superior potting attachment points. To better understand the load path and strain distribution through the rami a finite element model of a human pelvis was developed from computer tomography data and validated based on available published test data. Then, the lateral impact test was numerically simulated and the model responses were mostly within the min-max ranges of the test data. The test data and FE simulations showed that prior to the fracture the pubic symphysis joint transmitted the higher percentage of load (about 66% in dynamic tests). The strain distribution analysis of the impact pelvic tests showed that the pubic rami are subjected predominantly to compressive stress on the anterior side and tensile stress on the posterior side. While the anterior pubic side of the non-impact part of the pelvis was always subjected to compressive stress, some test variability was observed on other regions of the non-impact sides. In addition to providing validation data for computational models, the results highlight the vulnerability of pubic rami structure in carrying lateral load in acetabular impacts and may lend insight into the development of injury countermeasures.

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