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

Abstract

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.

A review of protein adsorption on bioceramics

“…The first generation is called inert ceramics, which aimed to substitute natural bone. For example, zirconia [49][50][51][52], titanium [53][54][55] and alumina [56][57][58] are primarily used in fabrication of femoral heads to substitute the damaged bones [59]. Although these ceramics are biocompatible, the living body usually reacts against the implants because they are foreign, and these implants themselves are likely to never transform into bone.…”

Improving the wear and corrosion resistance of CoCrMo-UHMWPE articulating surfaces in the presence of an electrolyte

“…Though such coatings were able to improve the wear resistance of CoCrMo head in abrasion against UHMWPE, the wear damage of UHMWPE was not reduced, as reported in [16]. On the other hand, Roy et al [17] reported better performance of zirconia femoral head than CoCr femoral heads in bringing a lower wear rate of the UHMWPE counterpart. Li et al [18] reported zirconia-graphene composite coating prepared by plasma spraying, which showed reduced wear rate in dry sliding wear test against alumina.…”

Problematic Issues of the Theory and Practice of Finger Joints Endoprosthetics (Literature Review)

“…Застосовуються конструкції з цементним типом фіксації переважно у хворих з ознаками остеопорозу, їх не рекомендується використовувати у пацієнтів молодого віку. Також при ревізійних операціях видалення цементу з невеликих кісток пов'язано з певними технічними труднощами [15,16].…”