Advantages and disadvantages of ceramic on ceramic total hip arthroplasty: A review

Gallo, Jiří; Goodman, Stuart B.; Lošťák, J; Janout, Martin

doi:10.5507/bp.2012.063

Cited by 62 publications

(48 citation statements)

References 79 publications

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“…In this line, there is evidence that bearing surfaces strongly predict the fate of a THA [39,40]. Very low rate of aseptic loosening observed in the present study could be associated at least in part with a low mean polyethylene wear rate.…”

Section: Discussionsupporting

confidence: 65%

Long-term survival of the uncemented Balgrist total hip replacement cup

Gallo

Lošťák

Langová

2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the longterm clinical and radiographic outcomes of the Balgrist total hip replacement cup. Methods We report the results of a retrospective review of 195 total hip prostheses with Balgrist cup implanted in 178 patients. There were 59 men and 119 women with a mean age at surgery of 52.3 years (range, 19-72). Cox regression was used to determine the influence of independent variables on the survivorship of the prosthesis. Results There were 117 (66 %) of 178 patients, and 131 (67 %) of 195 hips available for assessment at a mean follow-up of 17.4 years. A total of 21 patients (22 hips) were lost from follow-up (12 %). A total of 25 patients (27 hips) required some type of re-operation during the follow-up period. Eight of 27 re-operations (30 %) were directly caused by the Balgrist cup failure due to fatigue fracture of the metallic shell (n=5; 19 %), polyethylene wear (n=2; 7 %) and aseptic loosening (n=1; 4 %). The mean polyethylene wear rate was 0.068 mm/year (range, 0.008-0.230; SD=0.043). The risk of re-operation for any reason was decreased with dysplastic hip as a primary diagnosis (hazard ratio; HR=0.250; 95 % CI 0.086-0.725) and with greater age at the time of surgery (HR =0.923; 95 % CI 0.880-0.969). The 19-year survivorship with re-operation for any reason was 75.6 % (95 % CI 67.0-84.2). The 19-year survivorship with re-operation for the Balgrist cup failure was 90.5 % (95 % CI 83.4-97.6).Conclusions The Balgrist cup continues to provide excellent clinical and radiological outcomes. This is associated at least in part with a low polyethylene wear rate. The main reason for the Balgrist cup failure is fatigue fracture of the metallic shell.

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Section: Discussionsupporting

confidence: 65%

Long-term survival of the uncemented Balgrist total hip replacement cup

Gallo

Lošťák

Langová

2013

International Orthopaedics (SICOT)

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“…Another important current concern in conventional hard-on-hard bearings is the squeaking phenomenon that results in audible noise during walking [38][39][40][41]. Explanations about the origin of such phenomenon are vast, including malpositioning, disruption of fluid film lubrication, stripe wear, and entrapment of third-body wear debris [38][39][40][41]. This phenomenon can be also observed in wear simulator experiments with ceramic components when third body particles are added to the contact region [41].…”

Section: Wear Rate Evaluationmentioning

confidence: 99%

“…With this in mind, even if wear debris are released to the body, the problem of inflammations and aseptic loosening of conventional systems can be avoided when using all-NCD joints. Another important current concern in conventional hard-on-hard bearings is the squeaking phenomenon that results in audible noise during walking [38][39][40][41]. Explanations about the origin of such phenomenon are vast, including malpositioning, disruption of fluid film lubrication, stripe wear, and entrapment of third-body wear debris [38][39][40][41].…”

Section: Wear Rate Evaluationmentioning

confidence: 99%

The High performance of nanocrystalline CVD diamond coated hip joints in wear simulator test

Maru

Amaral

Rodrigues

et al. 2015

Journal of the Mechanical Behavior of Biomedical Materials

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The superior biotribological performance of nanocrystalline diamond (NCD) coatings grown by a chemical vapor deposition (CVD) method was already shown to demonstrate high wear resistance in ball on plate experiments under physiological liquid lubrication. However, tests with a close-to-real approach were missing and this constitutes the aim of the present work. Hip joint wear simulator tests were performed with cups and heads made of silicon nitride coated with NCD of ~10 μm in thickness. Five million testing cycles (Mc) were run, which represent nearly five years of hip joint implant activity in a patient. For the wear analysis, gravimetry, profilometry, scanning electron microscopy and Raman spectroscopy techniques were used. After 0.5 Mc of wear test, truncation of the protruded regions of the NCD film happened as a result of a fine-scale abrasive wear mechanism, evolving to extensive plateau regions and highly polished surface condition (Ra<10nm). Such surface modification took place without any catastrophic features as cracking, grain pullouts or delamination of the coatings. A steady state volumetric wear rate of 0.02 mm(3)/Mc, equivalent to a linear wear of 0.27 μm/Mc favorably compares with the best performance reported in the literature for the fourth generation alumina ceramic (0.05 mm(3)/Mc). Also, squeaking, quite common phenomenon in hard-on-hard systems, was absent in the present all-NCD system.

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“…Another well-known ceramic material for structural applications is silicon nitride (Si 3 N 4 ), which presents a marked fracture toughness value of 10 MPa m 1/2 [7] higher than 6.5 MPa m 1/2 from ZTA [8]. Indeed, Si 3 N 4 ceramics were far-seeing proposed by Zhou et al [9] as a structural material for articular implants, and in the last decade by others [7,[10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 97%