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Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study
BACKGROUND: Most contemporary total disc replacements (TDRs) use conventional orthopaedic bearing couples such as ultrahigh-molecular-weight polyethylene (polyethylene) and cobalt-chromium (CoCr). Cervical total disc replacements incorporating polyetheretherketone (PEEK) bearings (specifically PEEK-...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052213/ https://www.ncbi.nlm.nih.gov/pubmed/27677290 http://dx.doi.org/10.1007/s11999-016-5041-7 |
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author | Siskey, Ryan Ciccarelli, Lauren Lui, Melissa K. C. Kurtz, Steven M. |
author_facet | Siskey, Ryan Ciccarelli, Lauren Lui, Melissa K. C. Kurtz, Steven M. |
author_sort | Siskey, Ryan |
collection | PubMed |
description | BACKGROUND: Most contemporary total disc replacements (TDRs) use conventional orthopaedic bearing couples such as ultrahigh-molecular-weight polyethylene (polyethylene) and cobalt-chromium (CoCr). Cervical total disc replacements incorporating polyetheretherketone (PEEK) bearings (specifically PEEK-on-PEEK bearings) have been previously investigated, but little is known about PEEK-on-ceramic bearings for TDR. QUESTIONS/PURPOSES: (1) What is the tribologic behavior of a PEEK-on-ceramic bearing for cervical TDR under idealized, clean wear test conditions? (2) How does the PEEK-on-ceramic design perform under impingement conditions? (3) How is the PEEK-on-ceramic bearing affected by abrasive wear? (4) Is the particle morphology from PEEK-on-ceramic bearings for TDRs affected by adverse wear scenarios? METHODS: PEEK-on-ceramic cervical TDR bearings were subjected to a 10 million cycle ideal wear test based on ASTM F2423 and ISO 181912-1 using a six-station spine wear simulator (MTS, Eden Prairie, MN, USA) with 5 g/L bovine serum concentration at 23° ± 2° C (ambient temperature). Validated 1 million cycle impingement and 5 million cycle abrasive tests were conducted on the PEEK-on-ceramic bearings based, in part, on retrieval analysis of a comparable bearing design as well as finite element analyses. The ceramic-on-PEEK couple was characterized for damage modes, mass and volume loss, and penetration and the lubricant was subjected to particle analysis. The resulting mass wear rate, volumetric wear rate, based on material density, and particle analysis were compared with clinically available cervical disc bearing couples. RESULTS: The three modes of wear (idealized, impingement, and abrasive) resulted in mean mass wear rates of 0.9 ± 0.2 mg/MC, 1.9 ± 0.5 mg/MC, and 2.8 ± 0.6 mg/MC, respectively. The mass wear rates were converted to volumetric wear rates using density and found to be 0.7 ± 0.1 mm(3)/MC, 1.5 ± 0.4 mm(3)/MC, and 2.1 ± 0.5 mm(3)/MC, respectively. During each test, the PEEK endplates were the primary sources of wear and demonstrated an abrasive wear mechanism. Under idealized and impingement conditions, the ceramic core also demonstrated slight polishing of the articulating surface but the change in mass was unmeasurable. During abrasive testing, the titanium transfer on the core was shown to polish over 5 MC of testing. In all cases and consistent with previous studies of other PEEK bearing couples, the particle size was primarily < 2 µm and morphology was smooth and spheroidal. CONCLUSIONS: Overall, the idealized PEEK-on-ceramic wear rate (0.7 ± 0.1 mm(3)/MC) appears comparable to the published wear rates for other polymer-on-hard bearing couples (0.3–6.7 mm(3)/MC) and within the range of 0.2 to 1.9 mm(3)/MC reported for PEEK-on-PEEK cervical disc designs. The particles, based on size and morphology, also suggest the wear mechanism is comparable between the PEEK-on-ceramic couple and other polymer-on-ceramic orthopaedic couples. CLINICAL RELEVANCE: The PEEK-on-ceramic bearing considered in this study is a novel bearing couple for use in total disc arthroplasty devices and will require clinical evaluation to fully assess the bearing couple and total disc design. However, the wear rates under idealized and adverse conditions, and particle size and morphology, suggest that PEEK-on-ceramic bearings may be a reasonable alternative to polyethylene-on-CoCr and metal-on-metal bearings currently used in cervical TDRs. |
format | Online Article Text |
id | pubmed-5052213 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-50522132016-10-20 Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study Siskey, Ryan Ciccarelli, Lauren Lui, Melissa K. C. Kurtz, Steven M. Clin Orthop Relat Res Symposium: Advances in PEEK Technology BACKGROUND: Most contemporary total disc replacements (TDRs) use conventional orthopaedic bearing couples such as ultrahigh-molecular-weight polyethylene (polyethylene) and cobalt-chromium (CoCr). Cervical total disc replacements incorporating polyetheretherketone (PEEK) bearings (specifically PEEK-on-PEEK bearings) have been previously investigated, but little is known about PEEK-on-ceramic bearings for TDR. QUESTIONS/PURPOSES: (1) What is the tribologic behavior of a PEEK-on-ceramic bearing for cervical TDR under idealized, clean wear test conditions? (2) How does the PEEK-on-ceramic design perform under impingement conditions? (3) How is the PEEK-on-ceramic bearing affected by abrasive wear? (4) Is the particle morphology from PEEK-on-ceramic bearings for TDRs affected by adverse wear scenarios? METHODS: PEEK-on-ceramic cervical TDR bearings were subjected to a 10 million cycle ideal wear test based on ASTM F2423 and ISO 181912-1 using a six-station spine wear simulator (MTS, Eden Prairie, MN, USA) with 5 g/L bovine serum concentration at 23° ± 2° C (ambient temperature). Validated 1 million cycle impingement and 5 million cycle abrasive tests were conducted on the PEEK-on-ceramic bearings based, in part, on retrieval analysis of a comparable bearing design as well as finite element analyses. The ceramic-on-PEEK couple was characterized for damage modes, mass and volume loss, and penetration and the lubricant was subjected to particle analysis. The resulting mass wear rate, volumetric wear rate, based on material density, and particle analysis were compared with clinically available cervical disc bearing couples. RESULTS: The three modes of wear (idealized, impingement, and abrasive) resulted in mean mass wear rates of 0.9 ± 0.2 mg/MC, 1.9 ± 0.5 mg/MC, and 2.8 ± 0.6 mg/MC, respectively. The mass wear rates were converted to volumetric wear rates using density and found to be 0.7 ± 0.1 mm(3)/MC, 1.5 ± 0.4 mm(3)/MC, and 2.1 ± 0.5 mm(3)/MC, respectively. During each test, the PEEK endplates were the primary sources of wear and demonstrated an abrasive wear mechanism. Under idealized and impingement conditions, the ceramic core also demonstrated slight polishing of the articulating surface but the change in mass was unmeasurable. During abrasive testing, the titanium transfer on the core was shown to polish over 5 MC of testing. In all cases and consistent with previous studies of other PEEK bearing couples, the particle size was primarily < 2 µm and morphology was smooth and spheroidal. CONCLUSIONS: Overall, the idealized PEEK-on-ceramic wear rate (0.7 ± 0.1 mm(3)/MC) appears comparable to the published wear rates for other polymer-on-hard bearing couples (0.3–6.7 mm(3)/MC) and within the range of 0.2 to 1.9 mm(3)/MC reported for PEEK-on-PEEK cervical disc designs. The particles, based on size and morphology, also suggest the wear mechanism is comparable between the PEEK-on-ceramic couple and other polymer-on-ceramic orthopaedic couples. CLINICAL RELEVANCE: The PEEK-on-ceramic bearing considered in this study is a novel bearing couple for use in total disc arthroplasty devices and will require clinical evaluation to fully assess the bearing couple and total disc design. However, the wear rates under idealized and adverse conditions, and particle size and morphology, suggest that PEEK-on-ceramic bearings may be a reasonable alternative to polyethylene-on-CoCr and metal-on-metal bearings currently used in cervical TDRs. Springer US 2016-09-27 2016-11 /pmc/articles/PMC5052213/ /pubmed/27677290 http://dx.doi.org/10.1007/s11999-016-5041-7 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Symposium: Advances in PEEK Technology Siskey, Ryan Ciccarelli, Lauren Lui, Melissa K. C. Kurtz, Steven M. Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study |
title | Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study |
title_full | Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study |
title_fullStr | Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study |
title_full_unstemmed | Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study |
title_short | Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study |
title_sort | are peek-on-ceramic bearings an option for total disc arthroplasty? an in vitro tribology study |
topic | Symposium: Advances in PEEK Technology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052213/ https://www.ncbi.nlm.nih.gov/pubmed/27677290 http://dx.doi.org/10.1007/s11999-016-5041-7 |
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