Effect of inward-outward rotation on hip wear simulation.

The ISO 14242-1 standard specifies a three-axis motion for the wear testing of prosthetic hips. Multidirectionality of the relative motion and serum-based lubrication are known to be necessary for the reproduction of clinical wear mechanisms. For multidirectionality however, biaxial motion has been shown to be sufficient. To a biaxial hip joint simulator that incorporated flexion-extension (FE, range 46°) and abduction-adduction (AA, range 12°), a third motion component, inward-outward rotation (IOR, range 12°) was added according to the ISO 14242-1 standard. Due to the addition of the IOR, the wear rate of vitamin E stabilized, extensively cross-linked polyethylene (VEXLPE) liners decreased by 50 per cent. This was probably attributable to the increased linearity of the relative motion in the stance phase, caused by the simplified motion waveforms and their relative phases specified in the standard. In order not to underestimate the wear rate, the established biaxial motion is preferred.