Effect of Component Position and Inward–Outward Rotation on the Wear of Different Ultra-High Molecular Weight Polyethylenes in an Orbital Bearing Type Hip Joint Simulator

The orbital bearing machine is the world’s most widely used hip joint simulator design for wear testing of prosthetic hips. It has been used with inverted and anatomic component position and with and without inward–outward rotation. Still the effect of component position on the wear of the most widely used bearing material, ultrahigh molecular weight polyethylene (UHMWPE), has not been studied directly. With a modified orbital bearing machine, the effects of the component position, anatomic versus inverted, and of the inward–outward rotation, present versus absent, on polyethylene wear were studied for the first time. Acetabular liners made from different ultra-high molecular weight polyethylenes articulated against alumina femoral heads in alpha calf serum. The inverted position resulted in the most realistic, burnished appearance of the polyethylene bearing surfaces. In the inverted position, the wear rate decreased with increasing gamma dose that is known to improve wear resistance by cross-linking. In the anatomic position, the bearing surface was not always entirely burnished. The wear was similar with and without inward–outward rotation. The mean wear rate of vitamin E stabilized highly cross-linked ultra-high molecular weight polyethylene was close to clinical observations. Clinically relevant wear could be produced with the orbital bearing machine for both established and advanced bearing materials. The inverted position appeared preferable in the orbital bearing machine. Inward–outward rotation did not appear important.