Tribology of human and artificial joints.

Studies of human joint lubrication mechanisms have led to the conclusion that under normal healthy conditions they are fluid film lubricated. The main features responsible for allowing this mechanism to operate are the dynamic nature of the loading and the compliance of the bearing surfaces (articular cartilage). In contrast, artificial joints, being made of much more rigid materials, have been demonstrated to be lubricated by a mixed regime, where some load is carried by the fluid film and some by solid to solid contact. Since some surface contact takes place then wear remains a problem and friction is much higher than in human joints. The use of compliant surface bearings for artificial joints has been explored and shown to be of great advantage, reproducing the effects of natural joints. However, elastomeric materials are known to degrade in aqueous solutions so this aspect has been examined to ensure a reasonable life in the human body. Joints of the lower limb--hip, knee, and ankle--have similar load and motion patterns and behave in a similar way in terms of lubrication. Joints of the hand are not in any way similar in their behaviour and so a typical upper limb joint, the finger, has been studied to see if improvements can be made to the design of replacement artificial joints. Novel suggestions like plastic on plastic joints have been shown to be an alternative which is worthy of further consideration.