Wear paths produced by individual hip-replacement patients— A large-scale, long-term follow-up study

Wear particle accumulation is one of the main contributors to osteolysis and implant failure in hip replacements. Altered kinematics produce significant differences in wear rates of hip replacements in simulator studies due to varying degrees of multidirectional motion. Gait analysis data from 153 hip-replacement patients 10-years post-operation were used to model two- and three-dimensional wear paths for each patient. Wear paths were quantified in two dimensions using aspect ratios and in three dimensions using the surface areas of the wear paths, with wear-path surface area correlating poorly with aspect ratio. The average aspect ratio of the patients wear paths was 3.97 (standard deviation ¼ 1.38), ranging from 2.13 to 10.86. Sixty percent of patients displayed aspect ratios between 2.50 and 3.99. However, 13% of patients displayed wear paths with aspect ratios 45.5, which indicates reduced multidirectional motion. The majority of total hip replacement (THR) patients display gait kinematics which produce multidirectional wear paths, but a significant minority display more linear paths.

The influence of wear paths produced by hip replacement patients during normal walking on wear rates

Variation in wear paths is known to greatly affect wear rates in vitro, with multidirectional paths producing much greater wear than unidirectional paths. This study investigated the relationship between multidirectional motion at the hip joint, as measured by aspect ratio, sliding distance, and wear rate for 164 hip replacements. Kinematic input from three-dimensional gait analysis was used to determine the wear paths. Activity cycles were determined for a subgroup of 100 patients using a pedometer study, and the relationship between annual sliding distance and wear rate was analyzed. Poor correlations were found between both aspect ratio and sliding distance and wear rate for the larger group and between annual sliding distance and wear rate for the subgroup. However, patients who experienced a wear rate <0.08 mm/year showed a strong positive correlation between the combination of sliding distance, activity levels, and aspect ratio and wear rate (adjusted r2?=?55.4%). This group may represent those patients who experience conditions that most closely match those that prevail in simulator and laboratory tests. Although the shape of wear paths, their sliding distance, and the number of articulation cycles at the hip joint affect wear rates in simulator studies, this relationship was not seen in this clinical study. Other factors such as lubrication, loading conditions and roughness of the femoral head may influence the wear rate.

A comparison of the strengths of gastropod shells with forces generated by potential crab predators

Carcinus manenas, Liocarcinus puber and Cancer pagurs are thought to be three likely crab predators of the gastropod Calliostoma Zizyphinum. In order to compare the strenghts of predators and their prey, the whole shell and aperture lip strengh of white and pink Calliostoma morphotypes and the maximum forces exerted by the chelipeds of three crab species were measured. Although white shells were thicker than pink shells, Calliostoma colour morphotyes did not differ significantly in either the force required to break the shell lip or the whole shell. Both Liocarcinus puber and Carcinus maenas have dimorphic chelipeds and their “crusher” chelipeds deliver almost double the forces generated by the‘cutter’chelipeds. In constrast, Cancer pagurus has monomorphic chelipeds both delivering similar forces. When compared with Calliostoma shell strenght, the forces generated by the‘crusher’chelipeds of most L. puber tested were, in general, sufficient to break the shell lip of Calliostoma shells, whereas forces generated by the‘cutter’chelipeds of only the larger individuals were sufficient to break the shell lip. In C. manenas, forces generated by both the‘cutter’and‘crusher’chelipeds often exceeded the minimum recorded force required to break the shell lip and the‘crusher’cheliped reached the minimum force required to break whole Calliostoma shells. Both chelipeds of all C. pagurus tested generated forces in excess of the minimum required to break the shell lip, and the proportion of individuals capable of generating the minimum force required to break the whole shell increased with the size of the size of the crab. Carcinus maenas and Cancer pagurus were capable of breaking both the shell lips and the whole shells of a wider range of shell sizes than L. puber.