Comparison of cobalt chromium, ceramic and pyrocarbon hemiprostheses in a rabbit model: Ceramic leads to more cartilage damage than cobalt chromium

Abstract

Cartilage wear after hemiarthroplasty remains a problem in orthopedic surgery. The main cause of cartilage wear, apart from incongruency of the joint partners, is generally considered to be the tribology of the material surfaces. This study evaluates in 27 rabbits the degree of cartilage wear of the tibia plateau after hemiarthroplasty with proximal interphalangeal prostheses made of three different materials [cobalt chromium (CoCr), pyrocarbon (PyCa), and ceramic (Cer)]. Three months after hemiarthroplasty, the articulating tibial cartilage was histomorphologically examined and degenerative damage was graded using the modified Mankin score. The mechanical capacity of the cartilage was assessed by stress relaxation testing. The biomechanical properties of the cartilage were significantly superior in the CoCr group as compared with the Cer group (p < 0.03), indicating less damage to the articulating cartilage surface. The Mankin score showed significantly lower values in the CoCr compared with Cer group (p = 0.011), whereas no differences were found between PyCa and CoCr or PyCa and Cer. In contrast to earlier reports, in this hemiarthroplasty model, the CoCr alloy showed less cartilage damage than a ceramic surface. Further, in vivo experiments are necessary to elucidate the controversial issue of the most suitable material for hemiarthroplasty.

A 10-Year Follow-Up of Uncemented Constrained Metacarpophalangeal Joint Arthroplasties Using the RM Prosthesis in a Patient with Rheumatoid Arthritis.

“…Intraoperative periprosthetic fracture in MCPJ arthroplasty such as in our case is a concern, its occurrence is reported to be 3% associated with an increased risk with the use of pyrocarbon implants, cementless fixation of components such as in our case, and in the presence of diabetes mellitus [26]. Ceramic prostheses for replacement of the small joints in the hand are discussed in general in the literature critically [27][28][29][30].…”

Analysis of frictional behavior and changes in morphology resulting from cartilage articulation with porous polyurethane foams

“…[7][8][9] All of these materials are chosen to optimize either the mechanical load support or the cellular environment, with few materials optimizing both. Investigation of the frictional properties of cartilagematerial interfaces focuses almost entirely on nonporous, single-phase materials including ceramics, metals, and metal alloys [3][4][5][10][11][12] with limited studies aimed at understanding the frictional properties of interfaces between cartilage and polymers used for soft tissue replacement. [13][14][15] Lubrication of joint tissues is believed to occur through various mechanisms [16][17][18][19][20][21] and within different modes.…”

Establishing a live cartilage-on-cartilage interface for tribological testing

“…There were two objectives for the study: (I) to design and test a system applying complex articulating motion to a living cartilage-on-cartilage (CoC) interface with comparison to a metal-on-cartilage (MoC) interface to evaluate system sensitivity; (II) to evaluate the effect of rolling and gliding motion on the biological response and its impact on matrix wear through comparing living and dead tissue. The MoC interface was chosen to evaluate system sensitivity because it is used clinically in hemiarthroplasties that are expected to last a decade, implying they produce only limited cartilage damage (but still more than CoC)[33–35]. In spite of this limited damage, a successful test set-up must be able to discriminate cartilage wear differences between the CoC and MoC pairings.…”