Wear of ultra-high molecular weight polyethylene and polytetrafluoroethylene in a hip simulator: a dose-response study of protein concentration.

Charnley's laboratory wear studies of non-gamma sterilized polytetrafluoroethylene (PTFE) and polyethylene (PE) found that the PTFE to PE wear-rate ratio of 250:1 was much higher than the in-vivo wear ratio of 20:1. Tests of PTFE and PE in our laboratory showed a wear ratio of 150:1, using bovine serum as the lubricant and 190:1 with water as the lubricant. Our hypothesis was that the wear-rates of PTFE and PE cup materials were related to the concentration of protein in the serum. We studied the wear behavior of PTFE and PE cups in varied protein concentrations, using 4 femoral head sizes to validate the clinical range reported by Charnley. The PTFE wear-rates increased with increasing protein concentration and conversely, PE wear-rates decreased with increasing protein concentration. This inverse relationship made it possible to bring the wear ratio closer to the desired clinical wear ratio. We found that the clinically relevant PTFE/PE wear ratio corresponded to 3-10 mg/mL of protein in bovine serum.