Current Status of Zirconia Used in Total Hip Implants

Clarke, Ian C.; Manaka, M.; Green, D. D.; Williams, Paul A.; Pezzotti, Giuseppe; Kim, Y.-h.; Ries, Michael D.; Sugano, Nobuhiko; Sedel, L.; Delauney, C.; Nissan, Besim Ben; Donaldson, Thomas; Gustafson, Gösta

doi:10.2106/00004623-200300004-00009

Cited by 222 publications

(149 citation statements)

References 17 publications

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“…The study from England used zirconia ceramic heads and chemically, cross-linked cups. Despite some concerns raised by other groups using zirconia (Clarke et al 2003), this study continues with excellent results and no reoperations to date (Wroblewski et al 2000).…”

mentioning

confidence: 64%

Micro-wear features on unique 100-Mrad cupsTwo retrieved cups compared to hip simulator wear study

Yamamoto

Masaoka

Manaka

et al. 2004

Acta Orthopaedica Scandinavica

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mentioning

confidence: 64%

Micro-wear features on unique 100-Mrad cupsTwo retrieved cups compared to hip simulator wear study

Yamamoto

Masaoka

Manaka

et al. 2004

Acta Orthopaedica Scandinavica

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“…In the mideighties, zirconia ceramics were introduced to the orthopaedic prostheses market as a promising alternative to the well established alumina femoral heads for total hip replacement (Christel et al, 1988). It was expected that zirconia, with two to three times higher flexural strength than alumina, would be an improvement on the higher fracture incidence of the alumina implants (Clarke et al, 2003;Piconi et al, 2003). However, even though some reports indicated that zirconia exhibited an exceptionally low fracture incidence of 0.002% (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…However, even though some reports indicated that zirconia exhibited an exceptionally low fracture incidence of 0.002% (i.e. 1:46,000), other zirconia heads produced by the same manufacturer had a disastrous performance (Clarke et al, 2003). In 2001, more than 350 zirconia femoral heads from St. Gobain Desmarquest (France) were retrieved from patients due to an unexpectedly high fracture rate (Chevalier, 2006;Chevalier et al, 2007;FDA, 2001).…”

Section: Introductionmentioning

confidence: 99%

“…The company named an external scientific advisory committee intended to understand the failure causes. They concluded that the combination of a new sintering process in a tunnel furnace and the subsequent machining operations yielded a more unstable surface prone to the accelerated transformation that caused the fractures (Clarke et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

“…As highlighted by Clarke et al (2003) and Chevalier (2006), the behaviour of zirconia ceramics is complicated to describe and thus commonly misunderstood due to the numerous variables that influence its performance. The purpose of the present study is to provide further insight into the interlinking effects of wear and transformation on the coupling surface of zirconia femoral heads by systematically characterizing retrieved implants using high resolution, fast and non-destructive techniques.…”

Section: Introductionmentioning

confidence: 99%

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Wear and degradation on retrieved zirconia femoral heads

Nogiwa-Valdez

Rainforth

Stewart

2014

Journal of the Mechanical Behavior of Biomedical Materials

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Zirconia femoral heads retrieved from patients after different implantation periods (up to 13 years) were analysed using vertical scanning interferometry, atomic force microscopy and Raman microspectroscopy. A range of topographical and compositional changes on the surface of the retrievals are reported in this work. The study revealed that changes in roughness are the result of a combination of factors, i.e. scratching, surface upheaval due to transformation to the monoclinic phase and grain pull-out. Clusters of transformed monoclinic grains were observed on heads implanted for more than 3 years. The phase composition of these clusters was confirmed by Raman microspectroscopy. Increased abrasive wear and a higher monoclinic phase content concentrated on the pole of the femoral heads, confirming that the tetragonal to monoclinic phase transformation was not only induced by the tetragonal phase metastability and environmental conditions but mechanical and tribological factors, also affected the transformation kinetics. Additionally, the head implanted for 13 years showed evidence of a self-polishing mechanism leading to a considerable smoothening of the surface. These observations provide an insight into the interrelated mechanisms underlying the wear and transformation process on zirconia ceramics during implantation.

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