The influence of lubricant temperature on the wear of total knee replacements

Experimental in vitro simulation can be used to predict the wear performance of total knee replacements. The in vitro simulation should aim to replicate the in vivo loading, motion and environment experienced by the joint, predicting wear and potential failure whilst minimising test artefacts. Experimental wear simulation can be sensitive to environmental conditions; the environment temperature is one variable which should be controlled and was the focus of this investigation. In this study, the wear of an all-polymer (PEEK-OPTIMA™ polymer-on-UHMWPE) total knee replacement and a conventional cobalt chrome-on-UHMWPE implant of similar initial surface topography and geometry were investigated under elevated temperature conditions. The wear was compared to a previous study of the same implants under simulator running temperature (i.e. without heating the test environment). Under elevated temperature conditions, the wear rate of the UHMWPE tibial inserts was low against both femoral component materials (mean <2 mm³/million cycles) and significantly lower (p < 0.05) than for investigations at simulator running temperature. Protein precipitation from the lubricant onto the component articulating surfaces is a possible explanation for the lower wear. This study highlights the need to understand the influence of different variables including environmental temperature to minimise the test artefacts during wear simulation which may affect the wear rates.