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The effect of anterior–posterior shear load on the wear of ProDisc-L TDR

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Abstract

The current wear-testing standard (ISO18192-1) for total disc replacement (TDR) requires only four degrees of freedom (DOF) inputs: axial load, flexion–extension, lateral bending and axial rotation. The study aim was to assess the effect of an additional DOF, anterior–posterior (AP) shear on the wear of the ProDisc-L TDR. A 5DOF simulator was used to test ProDisc-L implants under 4DOF and 5DOF conditions. The 4DOF conditions were defined by ISO18192-1 whilst the 5DOF used ISO18192-1 conditions with the addition of an AP load of +175 and −140 N (anterior and posterior, respectively), extrapolated from in vivo data. The implants were mounted such that the polyethylene insert could be removed for gravimetric measurements. Tests were run using bovine serum (15 g/l protein concentration) as a lubricant for five million cycles (MC), with measurements repeated every 1 MC. The mean wear rate in the 4DOF test was 12.7 ± 2.1 mg/MC compared to 11.6 ± 1.2 mg/MC in the 5DOF test. There were marked differences in the wear scars between 4DOF and 5DOF simulations. With 4DOF, wear scars were centralised on the dome of the insert, whilst 5DOF scars were larger, breaching the anterior rim of the dome causing deformation at the edge. The 4DOF wear test showed similar gravimetric wear rates to previously published ISO-tested TDRs. The addition of AP load was found to have no significant effect on the overall wear rate. However, there were pronounced differences in the respective wear scars, which highlights the need for more research in order to understand the factors that influence wear of TDR.

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Acknowledgments

This work was supported by the National Institutes of Health grant R01-AR052653 as part of a collaboration between the University of Leeds, University of Iowa, and Spine Centre Munich. Professor Fisher, Professor Ingham and Professor Hall receive support from the NHIR Leeds Musculoskeletal Biomedical Research Unit. The ProDisc-L implants were provided by Synthes Spine, Warsaw, Indiana, USA.

Conflict of interest statement

Professor Fisher is a Director of BITECIC Ltd and Tissue Regenix Ltd and a paid consultant to DePuy International, a Johnson & Johnson company. Professor Ingham is a shareholder of BITECIC Ltd and a Director of Tissue Regenix Ltd. Professor Brown is a paid consultant to Smith & Nephew Orthopaedics.

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Authors and Affiliations

  1. Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK

    R. Vicars, P. J. Hyde, J. L. Tipper, E. Ingham, J. Fisher & R. M. Hall

  2. Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, USA

    T. D. Brown

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  1. R. Vicars
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  2. P. J. Hyde
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  3. T. D. Brown
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  4. J. L. Tipper
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  5. E. Ingham
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  6. J. Fisher
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  7. R. M. Hall
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Correspondence to R. Vicars.

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Vicars, R., Hyde, P.J., Brown, T.D. et al. The effect of anterior–posterior shear load on the wear of ProDisc-L TDR. Eur Spine J 19, 1356–1362 (2010). https://doi.org/10.1007/s00586-010-1396-8

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  • DOI: https://doi.org/10.1007/s00586-010-1396-8

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