Differences in Highly Cross-Linked Polyethylene Wear Between Zirconia and Cobalt-Chromium Femoral Heads in Japanese Patients

Kawate, Kenji; Ohmura, Tetsuji; Kawahara, Ichiro; Tamai, Katsuya; Ueha, Tomoyuki; Takemura, Kazuo

doi:10.1016/j.arth.2009.05.023

Cited by 29 publications

(18 citation statements)

References 15 publications

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“…Laboratory studies [15,23,61] and clinical studies [15,20,22,62] showing a wear rate improvement conflict with other clinical reports [63][64][65] suggesting no apparent difference. Recently, a matched pair analysis was reported comparing 28 mm ceramic heads with the same size metal heads [66], bearing on conventional UHMWPE and found a significant reduction in wear rate at an average of 17 years post implantation, when ceramic heads were used.…”

Section: Open Accesscontrasting

confidence: 52%

Evaluation of Two Total Hip Bearing Materials for Resistance to Wear Using a Hip Simulator

John

2015

Lubricants

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Electron beam crosslinked ultra high molecular weight polyethylene (UHMWPE) 32 mm cups with cobalt alloy femoral heads were compared with gamma-irradiation sterilized 26 mm cups and zirconia ceramic heads in a hip wear simulator. The testing was performed for a total of ten million cycles with frequent stops for cleaning and measurement of mass losses due to wear. The results showed that the ceramic on UHMWPE bearing design exhibited higher early wear than the metal on highly crosslinked samples. Once a steady state wear rate was reached, the wear rates of the two types of hip bearing systems were similar with the ceramic on UHMPWE samples continuing to show a slightly higher rate of wear than the highly crosslinked samples. The wear rates of each of the tested systems appear to be consistent with the expectations for low rates of wear in improved hip replacement systems.

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Section: Open Accesscontrasting

confidence: 52%

Evaluation of Two Total Hip Bearing Materials for Resistance to Wear Using a Hip Simulator

John

2015

Lubricants

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“…The wear rate of zirconia, alumina, and CoCr in XLPE was 0.0008 ± 0.033, −0.0007 ± 0.037, and −0.009 ± 0.035 mm/year without significant differences among them. Kawate et al31 also reported no difference in wear of XLPE between zirconia and CoCr heads. This is the first study comparing the wear rate of zirconia and alumina heads, showing the effect of using XLPE is far more important than head material.…”

Section: Discussionmentioning

confidence: 95%

Wear resistant performance of highly cross‐linked and annealed ultra‐high molecular weight polyethylene against ceramic heads in total hip arthroplasty

Sato

Nakashima

Akiyama

et al. 2012

Journal Orthopaedic Research

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The purpose of this study was to examine the effects of ceramic femoral head material, size, and implantation periods on the wear of annealed, cross-linked ultra-high molecular weight polyethylene (UHMWPE) (XLPE) in total hip arthroplasty compared to non-cross-linked conventional UHMWPE (CPE). XLPE was fabricated by cross-linking with 60 kGy irradiation and annealing. Femoral heads made from zirconia and alumina ceramics and cobalt-chrome (CoCr) of 22 or 26 mm diameter were used. In this retrospective cohort study, the femoral head penetration into the cup was measured digitally on radiographs of 367 hips with XLPE and 64 hips with CPE. The average follow-up periods were 6.3 and 11.9 years, respectively. Both XLPE creep and wear rates were significantly lower than those of CPE (0.19 mm vs. 0.44 mm, 0.0001 mm/year vs. 0.09 mm/year, respectively). Zirconia displayed increased wear rates compared to alumina in CPE; however, there was no difference among head materials in XLPE (0.0008, 0.00007, and À0.009 mm/year for zirconia, alumina, and CoCr, respectively). Neither head size or implantation period impacted XLPE wear. In contrast to CPE, XLPE displayed low wear rates surpassing the effects of varying femoral head material, size, implantation period, and patient demographics. Further follow-up is required to determine the long-term clinical performance of the annealed XLPE. Keywords: polyethylene; wear; total hip arthroplasty; cross-linked; annealing Osteolysis is related to particulate ultra-high molecular weight polyethylene (UHMWPE) wear debris and is considered an important cause of aseptic loosening and late implant failure in total hip arthroplasty (THA). 1-3 Thus, UHMWPE wear is one of the major determinants influencing THA survivorship. Highly cross-linked UHMWPE (XLPE) is an alternative bearing surface developed to improve wear resistance and decrease osteolysis. XLPE has been studied extensively in vitro and has substantially decreased wear rates compared to non-cross-linked conventional UHMWPE (CPE) in hip simulator studies. 4,5 Preliminary clinical studies of XLPE in patients undergoing THA have confirmed these promising findings with a 30-80% reduction in wear compared to CPE at 3-5 years. 6,7 XLPE is fabricated using irradiation at 50-100 kGy for cross-linking and thermal treatment after irradiation to reduce free radicals and increase durability and cross-link density. Methods to prepare XLPE include radiation (gamma ray or electron beam), thermal treatment (remelted or annealed), and sterilization. 8 These methods, which influence mechanical properties, crystallinity, and oxidation states, are not equivalent, and the resulting clinical performances differ.The type of material and the size of femoral head are additional factors that influence wear. 9-12 Cobaltchromium alloy (CoCr) replaced stainless steel and titanium alloy due to its high wear resistance. 13

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“…Ceramic materials induced less wear than CoCr femoral heads in simulator studies [11,39,43], but recent clinical studies reported no difference in wear of XLPE liners bearing against Y-TZP and CoCr femoral heads [17,20,21,31,45]. The use of DLC coatings [14,25,33] has been proposed as a method to enhance bearing surfaces in joint replacement, but DLC-coated metal femoral heads failed in clinical use [47] and did not reduce wear in simulator tests [18].…”

Section: Discussionmentioning

confidence: 99%

“…In hip wear simulator studies, Y-TZP [4] femoral heads induced less UHMWPE wear compared with CoCr heads [11,39,43], and a clinical study of patients having bilateral THAs comparing the two materials found zirconia heads exhibited less wear than CoCr heads [23]. However, recent clinical studies have reported no reduction in cross-linked UHMWPE (XLPE) wear when using Y-TZP, often generically referred to as ''zirconia'' [34], compared with CoCr femoral heads [17,20,21,31,45]. The failure to reduce wear might be explained by phase transformation and degradation of the metastable Y-TZP femoral heads [10,15,16,26,36,37].…”

Section: Introductionmentioning

confidence: 99%

Reduced Wear of Cross-linked UHMWPE Using Magnesia-stabilized Zirconia Femoral Heads in a Hip Simulator

Roy

Whiteside

Magill

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background To reduce wear, the ideal bearing surface in joint arthroplasty should be smooth and hydrophilic. Ceramics generally offer better wettability than metals and can be polished to a smoother finish. However, clinical studies have found no reduction in liner wear when using yttria-stabilized zirconia (Y-TZP) instead of cobalt chromium alloy (CoCr) femoral heads. Question/purposes We (1) determined whether a hard, diamond-like carbon (DLC) coating would enhance the wettability of CoCr and magnesia-stabilized zirconia (Mg-PSZ) femoral heads without increasing roughness, and (2) compared their wear performance. Methods In an observational study limited to CoCr and Mg-PSZ heads, we measured roughness and contact angle on as-received and DLC-coated heads. Eight heads then were subjected to 11 million cycles of wear in a hip simulator against cross-linked ultrahigh molecular weight polyethylene (XLPE) liners.Results Mg-PSZ femoral heads were smoother and more hydrophilic than CoCr heads. Although DLC coatings did not reduce roughness, they reduced the contact angle of CoCr and Mg-PSZ substrates, which may provide enhanced lubrication in vivo. In hip simulator tests, liners bearing against CoCr heads wore at a greater rate compared with Mg-PSZ heads. The DLC coating on Mg-PSZ heads did not reduce wear further. Conclusions The wear rate of XLPE versus Mg-PSZ was seven times less than CoCr heads, probably owing to lower roughness and greater wettability of Mg-PSZ heads. Clinical relevance The use of Mg-PSZ femoral heads should lead to reduced wear in vivo compared with CoCr heads, but the clinical benefit of DLC-coated Mg-PSZ is unclear.

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Differences in Highly Cross-Linked Polyethylene Wear Between Zirconia and Cobalt-Chromium Femoral Heads in Japanese Patients

Cited by 29 publications

References 15 publications

Evaluation of Two Total Hip Bearing Materials for Resistance to Wear Using a Hip Simulator

Evaluation of Two Total Hip Bearing Materials for Resistance to Wear Using a Hip Simulator

Wear resistant performance of highly cross‐linked and annealed ultra‐high molecular weight polyethylene against ceramic heads in total hip arthroplasty

Reduced Wear of Cross-linked UHMWPE Using Magnesia-stabilized Zirconia Femoral Heads in a Hip Simulator

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