{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:51:34Z","timestamp":1787755894064,"version":"build-2784847793"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Wear debris is a known contributor to orthopaedic implant failure, particularly in joint arthroplasty. The wear characteristics of spinal total disc replacement (TDR) remain under-investigated. Spinal TDRs have been shown to produce wear particles that elicit strong inflammatory reactions. Submicron debris, in particular, is associated with osteolysis and implant loosening. Viscoelastic TDR (VTDR) devices have emerged to address these risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Five AxioMed Freedom Lumbar Disc (FLD) devices underwent 30 million cycles (10 million each in flexion-extension, lateral bending, and axial rotation) of wear testing in phosphate-buffered saline solution at 37\u00b0C using an MTS servohydraulic system. Wear fluid samples were collected every 5 million cycles and analyzed using scanning electron microscopy and laser diffraction. A 30-million device cycle count simulates 240 years of lumbar bending. Wear rates were calculated in milligrams per million cycles (mg\/MC). Comparative data for CHARIT\u00c9 (DePuy Synthes) and prodisc L (Centinel Spine) discs were obtained from the United States Food and Drug Administration (FDA) Summary of Safety and Effectiveness Data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The AxioMed device showed a mean wear rate of 1.7 mg\/MC, in comparison to 5.7 mg\/MC for the prodisc L. The number-average particle diameter was 1.9 \u03bcm, with a mass-average particle diameter of 49 \u03bcm, which was notably larger than those reportedly produced by the CHARIT\u00c9 (0.2 \u03bcm) and prodisc L (0.4 \u03bcm) devices, which is promising because larger particles (&gt;1.0 \u03bcm) are less likely to induce inflammatory responses. No mechanical failures were observed during the 30 million cycles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The AxioMed 1-piece VTDR device demonstrated a lower wear rate and larger, less biologically reactive, particles compared with articulating TDRs, suggesting a reduced risk of osteolysis and longer implant lifespan. No mechanical failures were observed, even after each 10-million-cycle interval, which simulates approximately 80 years of lumbar-bending motions. This study focused on particle size; further work is warranted to characterize composition and particle burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>This 1-piece VTDR may offer a safer and more durable alternative for motion-preserving lumbar spine surgery. Further clinical and retrieval studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.25.00594","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T19:01:31Z","timestamp":1764010891000},"page":"68-74","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Comparative in Vitro Analysis of Wear Particles Generated by a Viscoelastic Disc Versus 2 Articulating Total Disc Replacements"],"prefix":"10.2106","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2650-0229","authenticated-orcid":false,"given":"Kingsley R.","family":"Chin","sequence":"first","affiliation":[{"name":"Less Exposure Spine Surgery Institute (LESS Institute, aka LESS Clinic), Fort Lauderdale, Florida"},{"name":"LESS Institute of Jamaica, Kingston, Jamaica"},{"name":"Department of Orthopedics, Herbert Wertheim College of Medicine at Florida International University, Miami, 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Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4866-055X","authenticated-orcid":false,"given":"Erik","family":"Spayde","sequence":"additional","affiliation":[{"name":"St. Charles Spine Institute, Thousand Oaks, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Costigan","sequence":"additional","affiliation":[{"name":"Congress Orthopaedic Associates, Pasadena, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Thompson","sequence":"additional","affiliation":[{"name":"The Pain Center, Boise, Idaho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Lore","sequence":"additional","affiliation":[{"name":"Less Exposure Spine Surgery (LESS) Society, Fort Lauderdale, Florida"},{"name":"LESSpine, Burlington, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari B.","family":"Zimmers","sequence":"additional","affiliation":[{"name":"AxioMed, LLC, Burlington, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hope","family":"Estevez","sequence":"additional","affiliation":[{"name":"Less Exposure Spine Surgery Institute (LESS Institute, aka LESS Clinic), Fort Lauderdale, Florida"},{"name":"Less Exposure Spine Surgery (LESS) Society, Fort Lauderdale, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swapnil","family":"Pangarkar","sequence":"additional","affiliation":[{"name":"Less Exposure Spine Surgery (LESS) Society, Fort Lauderdale, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Humad","sequence":"additional","affiliation":[{"name":"Less Exposure Spine Surgery (LESS) Society, Fort Lauderdale, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chukwunonso C.","family":"Ilogu","sequence":"additional","affiliation":[{"name":"Less 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