Object: An understanding of the wear potential of total disc replacements (TDRs) is critical as these new devices are increasingly introduced into clinical practice. The authors analyzed the wear potential of a ProDisc-L implant using an adaptive finite element (FE) technique in a computational simulation representing a physical wear test.
Methods: The framework for calculating abrasive wear, first validated using a model of a total hip replacement (THR), was then used to model the ProDisc-L polyethylene component that is fixed to the inferior endplate and articulates with the rigid superior endplate. Proposed standards for spine wear testing protocols specified the inputs of flexion-extension (6/-3 degrees), lateral bending (+/- 2 degrees), axial twist (+/- 1.5 degrees), and axial load (200-1750 N or 600-2000 N) applied to the model through 10 million simulation cycles. The model was calibrated with a wear coefficient determined from an experimental wear test. Implicit FE analyses were then performed for variations in coefficient of friction, polyethylene elastic modulus, radial clearance, and polyethylene component thickness to investigate their effects on wear.
Results: Using the initial loading protocol (single-peaked axial load profile of 300-1750 N) from the experimental wear test, the polyethylene wear rate was 9.82 mg per million cycles. When a double-peaked loading profile (600-2000 N) was applied, the wear rate increased to 11.77 mg per million cycles. Parametric design variations produced only small changes in wear rates for this simulation.
Conclusions: The chosen design variables had little effect on the resultant wear rates. The comparable wear rate for the THR validation analysis was 16.17 mg per million cycles, indicating that, using this framework, the wear potential of the TDR was equivalent to, if not better, than the THR using joint-specific loading standards.