Normal and Adverse Wear Patterns Created In-Vivo on Metal-on-Metal Surfaces—A Retrieval Study Representing Four Vendors

Clarke, Ian C.; Donaldson, Thomas; Burgett, Michelle; Smith, Ella Thea; Bowsher, John G.; Savisaar, Christina; John, Anish; Lazennec, Jean-Yves; McPherson, Edward J.; Peters, Christopher L.

doi:10.1520/stp156020120049

Cited by 16 publications

(58 citation statements)

References 75 publications

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“…There were also frequent reports of ''stripe'' wear across heads and around cup rims [15,54,62,71,77]. Our MoM retrieval studies noted similar stripe damage in retrieved MoM [6,9,10], although other groups disavowed their existence [34]. Conventional MoM teaching is that the release of small surface carbides creates 0.5 to 5-lm wide scratches as a ''self-polishing'' mechanism [65,69,73].…”

Section: Introductionsupporting

confidence: 54%

“…1A: Type A) and one with a 205°cup-face angle (Type B). MoM bearings were examined for sites and patterns of habitual wear created by patient flexion-extension and abduction-adduction activities [5,9,33,56]. Bands of protein deposits were noted but not included for study [7].…”

Section: Standard Radiography and Eosmentioning

confidence: 99%

“…To determine cup impingement sites, each femoral head was mounted onto the femoral stem with the main wear zone pattern located superiorly. The cup was then rotated on the head to find impingement sites with the femoral neck and photographs taken [7,9].…”

Section: Standard Radiography and Eosmentioning

confidence: 99%

“…Micrometer measurements of internal liner geometry provided cup-face angles (CFA), cup-bearing angles (CBA), ROM, and polar-impingement angles (Fig. 1A) [9,23]. Liners were replicated in silicon (Aquasil-LV TM ; Densply, Milford, DE, USA) and the replicas sectioned for scanning electron microscopy (SEM) analysis (Fig.…”

Section: Standard Radiography and Eosmentioning

confidence: 99%

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Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Clarke

Lazennec

Savisaar

et al. 2013

Clin Orthop Relat Res

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Background Concerns have been raised about the sequelae of metal-on-metal (MoM) bearings in total hip arthroplasty (THA). However, retrieval studies, which offer the best insight into the clinically relevant mechanisms of MoM wear, have followed predictable trends to date such as indicting cobalt-chromium (CoCr) metallurgy, cup design, high conformity between the head and cup, ''steep cups,'' ''microseparation,'' and ''edge wear.'' Questions/purposes We wished to evaluate a set of retrieved 28-mm MoM THA for signs of (1) cup-to-stem impingement; (2) normal wear pattern and concomitant stripe damage on femoral heads that would signify adverse wear mechanics; and (3) well-defined evidence of thirdbody scratches on bearings that would indicate large abrasive particles had circulated the joint space. Methods Ten 28-mm MOM retrievals were selected on the basis that femoral stems were included. Revision surgeries at 3 to 8 years were for pain, osteolysis, and cup loosening. CoCr stems and the MoM bearings were produced by one vendor and Ti6Al4V stems by a second vendor. All but two cases had been fixed with bone cement. We looked for patterns of normal wear and impingement signs on femoral necks and cup rims. We looked for adverse wear defined as stripe damage that was visually apparent on each bearing. Wear patterns were examined microscopically to determine the nature of abrasions and signs of metal transfer. Graphical models recreated femoral neck and cup designs to precisely correlate impingement sites on femoral necks to cup positions and head stripe patterns.

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Section: Introductionsupporting

confidence: 54%

Section: Standard Radiography and Eosmentioning

confidence: 99%

Section: Standard Radiography and Eosmentioning

confidence: 99%

Section: Standard Radiography and Eosmentioning

confidence: 99%

See 2 more Smart Citations

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Clarke

Lazennec

Savisaar

et al. 2013

Clin Orthop Relat Res

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show abstract

“…However in MOM studies, impingement evidence has climbed to 96%. 8 We therefore sought evidence of roughening damage to the femoral heads as a result of 3rd-body wear. A study of MPE retrievals with average 12-years † Dept.…”

Section: Introductionmentioning

confidence: 99%