| The metallic femoral components of total knee replacements are subject to in vivo surface damage and roughening that can severely limit the service lifetime of the bearing system. To date, there are no national standards by which to characterize the severity and damage modes of these critical bearing surfaces, and therefore it remains difficult to accurately assess how femoral damage influences total joint replacement bearing longevity. In vitro and in vivo studies have shown that severe surface damage of the femoral component can occur, however, there is still no defined test methodology that can identify or replicate the types of surface damage seen in these components.;In this work, we developed, verified and translated a standardized experimental framework that can be used to identify, characterize and quantify clinically relevant damage mechanisms seen in retrieved femoral components. This framework characterizes the biomaterial surface damage condition using visual assessments and minimally-destructive quantitative assessments for surface damage modes, articular surface roughness and tribo-mechanical properties. Through a translational approach, we demonstrated the importance of the quantification and interpretation of the surface damage to further understand its effect on the long term performance of the TKR system. Finally, as part of our translational and educational objectives, we established a state-wide program for the systematic collection of joint replacements that not only serves as an educational platform to engage students in the evaluation of implant performance and failure mechanisms using the experimental framework, but also raises awareness about implant retrieval research, bioengineering and medical device performance. |
