New prospects for a prolonged functional life‐span of artificial hip joints by using the material combination polyethylene/aluminium oxide ceramic/metal

Semlitsch, M.; Lehmann, Michelle L.; Weber, H. P.; Doerre, E.; Willert, H.‐G.

doi:10.1002/jbm.820110409

Cited by 193 publications

(57 citation statements)

References 6 publications

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“…The advantage of using a ceramic head in combination with a polyethylene liner is a reduction in the wear rate compared with that of a metal head as an articulating partner. [28][29][30] Additionally, the method of polyethylene manufacture should be considered. In 1985, Sulzer Orthopedics obtained an essentially homogenous calcium stearate-free polyethylene with substantially improved wear behaviour.…”

Section: Discussionmentioning

confidence: 99%

Cementless total hip arthroplasty using a threaded cup and a rectangular tapered stem

Pospischill

Knahr

2005

The Journal of Bone and Joint Surgery. British volume

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We carried out a clinical and radiological review of 103 cementless primary hip arthroplasties with a tapered rectangular grit-blasted titanium press-fit femoral component and a threaded conical titanium acetabular component at a mean follow-up of 14.4 years (10.2 to 17.1).The mean Harris hip score at the last follow-up was 89.2 (32 to 100). No early loosening and no fracture of the implant were found. One patient needed revision surgery because of a late deep infection. In 11 hips (10.7%), the reason for revision was progressive wear of the polyethylene liner. Exchange of the acetabular component because of aseptic loosening without detectable liner wear was carried out in three hips (2.9%).After 15 years the survivorship with aseptic loosening as the definition for failure was 95.6% for the acetabular component and 100% for the femoral component.

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Section: Discussionmentioning

confidence: 99%

Cementless total hip arthroplasty using a threaded cup and a rectangular tapered stem

Pospischill

Knahr

2005

The Journal of Bone and Joint Surgery. British volume

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“…They noted that the measuring system could not distinguish between wear and creep, or cold flow, but they also confirmed a relatively large initial penetration which they attributed to creep, and found that alumina ceramic femoral heads penetrated more slowly than metal heads into polyethylene cups. Zichner and Willert (1992) questioned the validity of laboratory testing, since the simulator results of Semlitsch et al (1977) had suggested a 20:1 reduction in wear for the ceramic heads. We have now shown that clinical and laboratory simulator results can be in excellent accord.…”

Section: Discussionmentioning

confidence: 99%

Prospective Clinical and Joint Simulator Studies of a New Total Hip Arthroplasty Using Alumina Ceramic Heads and Cross-Linked Polyethylene Cups

Wroblewski¹,

Siney²,

Dowson³

et al. 1996

The Journal of Bone and Joint Surgery. British volume

238

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We report the findings from independent prospective clinical and laboratory-based joint-simulator studies of the performance of ceramic femoral heads of 22.225 mm diameter in cross-linked polyethylene (XLP) acetabular cups. We found remarkable qualitative and quantitative agreement between the clinical and simulator results for the wear characteristics with time, and confirmed that ceramic femoral heads penetrate the XLP cups at only about half the rate of otherwise comparable metal heads.In the clinical study, 19 hips in 17 patients were followed for an average of 77 months. In the hip-joint simulator a similar prosthesis was tested for 7.3 million cycles.Both clinical and simulator results showed relatively high rates of penetration over the first 18 months or 1.5 million cycles, followed by a very much lower wear thereafter. Once an initial bedding-in of 0.2 mm to 0.4 mm had taken place the subsequent rates of penetration were very small. The initial clinical wear during bedding-in averaged 0.29 mm/year; subsequent progression was an order of magnitude lower at about 0.022 mm/year, lower than the 0.07 mm/year in metal-to-UHMWP Charnley LFAs.Our results show the excellent tribological features of alumina-ceramic-to-XLP implants, and also confirm the value of well-designed joint simulators for the evaluation of total joint replacements.

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“…Theoretical advantages of ceramic compared with metal heads are that the smooth finish, hardness, and wettability lead to less friction, more lubrication, and less scratching between the bearing surfaces and thus lower rates of liner wear and osteolysis [37], although this is based on use of historical UHMWPE (gamma air-sterilized polyethylene) and older manufacturing processes of femoral heads that may not generalize to contemporary implants. One of the major concerns about ceramic heads, especially in ceramic-on-ceramic articulation, is the risk of component fracture; however, this has shown to be decreased in ceramic-on-polyethylene bearing surfaces [1,39].…”

Section: Introductionmentioning

confidence: 99%

Is There a Difference in Revision Risk Between Metal and Ceramic Heads on Highly Crosslinked Polyethylene Liners?

Cafri

Paxton

Love

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background The most common bearing surface used among primary THAs worldwide is a metal or ceramic femoral head that articulates against a highly crosslinked ultrahigh-molecular-weight polyethylene (HXLPE) acetabular liner. Despite their widespread use, relatively little is known about the comparative effectiveness of ceramic versus metal femoral heads with respect to risk of revision and dislocation as well as the role of head size in this relationship. Questions/purposes The purpose of this study was to evaluate the risk of (1) all-cause revision in metal versus ceramic femoral heads when used with an HXLPE liner, including an evaluation of the effect of head size; and (2) dislocation in metal versus ceramic femoral heads when used with an HXLPE liner as well as an assessment of the effect of head size. Methods Data were collected as part of the Kaiser Permanente Total Joint Replacement Registry between 2001 and 2013. Patients in this study were on average overweight (body mass index = 29 kg/m 2 ), 67 years old, mostly female (57%), and had osteoarthritis (93%) as the primary indication for surgery. The material of the femoral head (metal, ceramic) was crossed with head size (\ 32, 32, 36, [ 36 mm), yielding eight device groupings. Only uncemented devices were evaluated. The primary outcome was all-cause revision (n = 28,772) and the secondary outcome was dislocation within 1 year (n = 19,623). Propensity Conclusions The results did not provide evidence for use of one femoral head material over another when used with HXLPE liners for the outcome of revision, but for dislocation, metal performed better than ceramic with \ 32-mm heads. Overall, the findings suggest increased risk of revision/dislocation with head sizes \ 32 mm. Level of Evidence Level III, therapeutic study.

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New prospects for a prolonged functional life‐span of artificial hip joints by using the material combination polyethylene/aluminium oxide ceramic/metal

Cited by 193 publications

References 6 publications

Cementless total hip arthroplasty using a threaded cup and a rectangular tapered stem

Cementless total hip arthroplasty using a threaded cup and a rectangular tapered stem

Prospective Clinical and Joint Simulator Studies of a New Total Hip Arthroplasty Using Alumina Ceramic Heads and Cross-Linked Polyethylene Cups

Is There a Difference in Revision Risk Between Metal and Ceramic Heads on Highly Crosslinked Polyethylene Liners?

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