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Evaluation of impingement behaviour in lumbar spinal disc arthroplasty

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Abstract

Introduction

The objective of our in vitro study was to introduce a test method to evaluate impingement in lumbar spinal disc arthroplasty in terms of wear, contact pattern, metal ion concentration and particle release.

Material and Method

Impingement wear simulation was performed on a 6-station spinal wear simulator (Endolab, Germany) on a lumbar spinal disc system (activ® L Aesculap AG, Germany) using four different protocols specific to impingement in flexion, in extension, in lateral bending and in combined flexion bending. Impingement contact stress is intentionally created by applying an angular displacement of +2° in addition to the intended range of motion in the impingement direction, whereas a bending moment of 8 Nm remains constant during the impingement phase (plateau).

Results

An average volumetric wear rate of 0.67 mm3/million cycles was measured by impingement under flexion, of 0.21 mm3/million cycles under extension, of 0.06 mm3/million cycles under lateral bending and of 1.44 mm3/million cycles under combined flexion bending. The particle size distribution of the cobalt-chromium wear particles released by impingement in flexion (anterior), extension (posterior), lateral bending (lateral) and combined flexion bending (antero-lateral) revealed that most of the detected cobalt-chromium particles were in a size range between 0.2 and 2 µm.

Conclusion

The impingement wear simulation introduced here proved to be suitable to predict in vivo impingement behaviour in regard to contact pattern seen on retrieved devices of the activ® L lumbar disc arthroplasty design in a pre-clinical test.

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Acknowledgments

The authors would like to thank Sarah Mattes and Ricardo Smits Serena for their work on part of the particle analysis.

Conflict of interest

Five of the authors (TG, BF, CS, JS, WB) are employees of Aesculap Tuttlingen a manufacturer of orthopaedic implants. Two of the authors (JY, RG) are advising surgeons in Aesculap R&D projects. One of the authors (CK) is getting research funding in correlation with Aesculap R&D projects.

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Authors and Affiliations

  1. Aesculap AG Research and Development, Am Aesculap-Platz, 78532, Tuttlingen, Germany

    Thomas M. Grupp, Bernhard Fritz, Christoph Schilling, Jens Schwiesau & Wilhelm Blömer

  2. Ludwig Maximilians University Clinic for Orthopaedic Surgery, Campus Grosshadern, Munich, Germany

    Thomas M. Grupp

  3. Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA

    James J. Yue

  4. Orthopedic Care Center, Aventura, FL, USA

    Rolando Garcia Jr.

  5. EndoLab Mechanical Engineering GmbH, Thansau, Germany

    Christian Kaddick

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  1. Thomas M. Grupp
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Correspondence to Thomas M. Grupp.

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Grupp, T.M., Yue, J.J., Garcia, R. et al. Evaluation of impingement behaviour in lumbar spinal disc arthroplasty. Eur Spine J 24, 2033–2046 (2015). https://doi.org/10.1007/s00586-014-3381-0

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  • DOI: https://doi.org/10.1007/s00586-014-3381-0

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