26dkou57910.3205/26dkou579urn:nbn:de:0183-26dkou5795Meeting AbstractDouble-sided coatings on total knee replacements for considerable wear reductionRothammerRothammerBenedictBLehrstuhl für Konstruktionstechnik KTmfk, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, DeutschlandauthorNeusserNeusserKevinKLehrstuhl für Konstruktionstechnik KTmfk, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, DeutschlandauthorWartzackWartzackSandroSLehrstuhl für Konstruktionstechnik KTmfk, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, DeutschlandauthorGerman Medical Science GMS Publishing House
Düsseldorf
61020261020englThis is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung).M0659579Deutsche Gesellschaft für Orthopädie und UnfallchirurgieDeutsche Gesellschaft für Orthopädie und Orthopädische ChirurgieDeutsche Gesellschaft für UnfallchirurgieBerufsverband für Orthopädie und UnfallchirurgieDeutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026)Poster experimentell | VariaBerlin2026102020261023DKOU26_Abs_2472TextObjectives and questions: The research gap of this contribution addresses whether a double-sided amorphous carbon/diamondlike carbon (DLC) coating of TKRs can considerably reduce wear compared to uncoated Co28Cr6Mo (CoCr)|conventional UHMWPE (PE) or Ti6Al4V (Ti64)|PE in a knee simulator and thus significantly increase the service life of TKRs.Material and methods: The unconstrained, fixed-bearing TKR BPK-S Integration Knee System (Peter Brehm, size 4, left, γ-irradiation≈31.2±5.5 kGy) was used. Articulation partners were the femur/inlay pairs (n=3 + 1 axialreference): -CoCr|PE as gold standard/uncoated ref.,-Ti64|PE the comparative pairing/uncoated ref.,-and Ti64/a-C:H|PE/a-C:H as the decisive pairing to be investigated with a-C:H fully coated test group. Testing followed ISO 14243-1 in a four-station servo hydraulic knee simulator using a gait-cycle loading protocol (Stations S1-S3). Station S0 served as an axial-only soaked control for environmental correction. Prior to testing, PE inlays were soaked in 37 °C diluted bovine calf serum (DBCS) until mass stabilization to avoid soaking-related mass artifacts. Each articulation pair underwent 3.5 × 10⁶ gait cycles in DBCS. Gravimetric wear of the inlays was determined in compliance with ISO 14243-2 and correlated with volumetric wear-measurements carried out by comparing 3D-scans (Zeiss ATOS CS) after best fit alignment of unworn surfaces of S1-S3 Inlays to the axial reference of S0 to account for plastic deformation resulting from axial loading (Figure 1 ).Results: Overall, uncoated implants showed higher total wear compared to coated systems. After 3.5 × 10⁶ cycles, Ti64|PE showed the highest wear (23.7 ± 2.0 mg), followed by CoCr|PE (20.9 ± 1.6 mg). The fully coated Ti64/a‑C:H|PE/a‑C:H configuration demonstrated the lowest wear (9.0 ± 2.2 mg). Wear rates were 7.0 ± 1.0 mg/10⁶ cycles (Ti64|PE), 6.0 ± 0.4 mg/10⁶ cycles (CoCr|PE), and 2.1 ± 0.7 mg/10⁶ cycles (Ti64/a-C:H|PE/a-C:H). These results indicate a wear reduction of ≈ 57% vs. CoCr|PE and ≈ 62% vs. Ti64|PE when using fully coated systems. Wear rates were lower than those typically reported in literature, partly due to modified kinematic boundary conditions allowing greater tibial rotation.Discussion and conclusions: The experimental testing of TKRs demonstrated that a significant wear reduction was possible by DLC coatings. Due to the update of ISO14243, a quantitative comparison with previously published results regarding wear is, at present, not expedient. Also, the general limitations of a component tests under ideal conditions must be considered in order to derive well-founded, realistic wear predictions. Nevertheless, it can be stated that the service life of TKRs could be considerably increased by DLC coatings. However, detailed surface-analytical investigations of the coated components and generated wear particles are required to fully understand the underlying wear mechanisms.011