Tribology in Total Hip Arthroplasty PDF
Preview Tribology in Total Hip Arthroplasty
EFORT Reference in Orthopaedics and Traumatology Wolfhart Puhl George Bentley Klaus-Peter Günther Series Editors Tribology in Total Hip Arthroplasty Karl Knahr Editor Advances and Perspectives in Spinstructures and Spintrans- port 123 Tribology in Total Hip Arthroplasty Karl Knahr Editor Tribology in Total Hip Arthroplasty Editor Prim. Univ. Prof. Dr. Karl Knahr Orthopaedic Hospital Vienna-Speising 2nd Orthopaedic Department Speisinger Straße 109 1130 Vienna Austria [email protected] ISBN 978-3-642-19428-3 e-ISBN 978-3-642-19429-0 DOI 10.1007/978-3-642-19429-0 Springer Heidelberg Dordrecht London New York Library of Congress Control Number: 2011930549 © EFORT 2011 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lm or in any other way, and storage in data banks. 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Cover design: eStudioCalamar, Figueres/Berlin Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Preface Successful long-term results of total hip arthroplasty are mainly due to two facts: long-term stability of the implant and minimal wear of the articulating surfaces. Nowadays fi xation of the implant component appears to be a minor problem as both options – cementless fi xa- tion and fi xation using fourth generation cementing techniques – can achieve excellent long-term stability. Wear of the articulating components in total hip arthroplasty remains the most challeng- ing unsolved problem. The ideal bearing surface for total hip arthroplasty has been sought since the early days of this procedure. Beginning with polyethylene as a bearing surface by Sir John Charnley, a metal-on-metal bearing surface was introduced by McKee and Farrar to improve wear characteristics aiming at long-term survival of the implant. In the early 1970s Boutin initiated the fi rst ceramic-on-ceramic articulation in France. Since these pio- neering activities improvements in manufacturing techniques and materials have led to better long-term results – nevertheless each of these bearings have not only strengths but also weaknesses. Conventional polyethylene-–metal articulations are complicated long-term by wear debris and subsequent osteolysis and loosening. During recent years cross-linked polyeth- ylene has shown improved wear characteristics compared with conventional polyethylene. Recent reports suggest that we have not yet reached the fi nal stage of improvement as today vitamin E–stabilised cross-linked polyethylene is increasingly launched on the mar- ket. But, wear probably will not be as low as hard-on-hard bearings and we do not know if these new poylethylenes really can eliminate osteolysis especially in young and active patients. The major advantage of ceramic-on-ceramic is its very low wear. But – there is still concern because of squeaking and fracture of the ceramic components. During the last decades ceramic technology has improved dramatically. Starting from a fracture risk of 1% in the 1980’s there is now a probability of fracture for the ceramic head of only 0.002% and for the ceramic inlay of 0.02%. This improvement in technology is still in progress. Current problems concerning ceramic-on-ceramic prostheses include squeaking phenom- ena leading to patient complaints and, in some cases, to revision of the articulation. Evaluation of all these cases could show that this problem is associated with special types of implants and imperfect surgical techniques, for example, stripe wear due to edge load- ing of the ceramic inlay. Metal-on-metal prostheses show low wear, no fracture risk and allow the largest femoral head-to-outside-cup-diameter-ratio. However, the concern here is the systemic metal ion v vi Preface level elevation and metal allergy resulting in local lymphocytic response. Recent reports of increasing failure rates using this material in resurfacing arthroplasty as well as in large- diameter head metal-on-metal articulations have caused offi cial warnings from some State authorities. Nevertheless, there are still high numbers of cases with excellent clinical results and no problems related to the metal articulation. Considering all these advantages and disadvantages we have to be aware that wear issues are still a challenge in achieving the ultimate goal of total hip arthroplasty – an implant which functions for the whole life of every single patient. Vienna, Austria Prim. Univ. Prof. Dr. Karl Knahr Contents Part I Basics in Tribology 1 Tribology of Hip Prostheses ............................................................................. 3 John Fisher 2 Biomechanics of Hip Arthroplasty .................................................................. 11 Michael M. Morlock, Nick Bishop, and Gerd Huber 3 Ceramic Hip Replacements: Wear Behavior Affects the Outcome – A Tribological and Clinical Approach .................................. 25 Meinhard Kuntz, Sylvia Usbeck, Thomas Pandorf, and Ricardo Heros 4 Tribology of Metal-on-Metal Bearings ............................................................ 41 Jasper Daniel and Amir Kamali 5 Highly Cross-Linked Polyethylenes ................................................................ 61 Robert M. Streicher Part II Ceramic Articulations 6 Are Noisy Ceramic-on-Ceramic Hips Linked to Periprosthetic Bone? ....... 73 Bernd Grimm, Alphons Tonino, and Ide Christiaan Heyligers 7 Noise Emissions in Total Hip Replacements, with an Emphasis on Ceramic-on-Ceramic and Ceramic- on-Metal Bearings and Different Articular Sizes ........................................................................... 85 Dick Ronald van der Jagt, Lipalo Mokete, Bradley Rael Gelbart, Kingsley Nwokeyi, and Anton Schepers 8 Head Size in Relation to Noise Occurrence in Ceramic-on-Ceramic Bearings ............................................................................................................. 91 Frank Hoffmann, Milan Jovanovic, and Michael Muschik 9 The Squeaking Phenomenon in Ceramic-on-Ceramic Bearings .................. 99 Alexandra Pokorny and Karl Knahr vii viii Contents Part III Metal Articulations 10 Ceramic Surface Engineering of the Articulating Surfaces Effectively Minimizes Wear and Corrosion of Metal-on-Metal Hip Prostheses ............ 113 Karel J. Hamelynck, David J. Woodnutt, Robin Rice, and Genio Bongaerts 11 Retrieval Wear Analysis of Metal-on-Metal Hip Resurfacing Implants Revised Due to Pseudotumours ....................................................... 121 Young-Min Kwon, Harinderjit S. Gill, David W. Murray, and Amir Kamali Part IV Polyethylene Articulations 12 Polyethylene Wear in Total Hip Arthroplasty for Suboptimal Acetabular Cup Positions and for Different Polyethylene Types: Experimental Evaluation of Wear Simulation by Finite Element Analysis Using Clinical Radiostereometric Measurements .......................... 135 Christian Wong and Maiken Stilling 13 Wear Analysis of Highly Cross-Linked Polyethylene in Total Hip Arthroplasty ...................................................................................................... 159 Charles R. Bragdon, Michael Doerner, and Henrik Malchau 14 Rates of Osteolysis in Well-Functioning Alumina-on-Highly Cross-Linked Polyethylene Bearing Cementless THA in Patients Younger than Fifty with Femoral Head Osteonecrosis.................................. 169 Young-Hoo Kim, Yoowang Choi, and Jun-Shik Kim 15 Osteolysis and Aseptic Loosening: Cellular Events Near the Implant ........ 181 Gema Vallés, Eduardo García-Cimbrelo, and Nuria Vilaboa Part V Miscellaneous 16 Cushion Form Bearings in Total Hip Arthroplasty: Nature’s Approach to the Synovial Joint Problem .......................................................................... 195 Antonio Moroni, Martha Hoque, Giovanni Micera, Riccardo Orsini, Emanuele Nocco, and Sandro Giannini 17 A Novel Model to Predict Wear in an Uncemented Hip Replacement with a Ceramic on Polyethylene Bearing ........................................................ 207 Simon Boyle, Peter Loughenbury, Phil Deacon, and Richard M. Hall 18 Comparative In Vivo Wear Measurement of Conventional and Modern Bearing Surfaces in Total Hip Replacements by the Use of POLYWARE® Computerized System ...................................... 217 Georgios Karydakis and Theofi los Karachalios Erratum ..................................................................................................................... E1 Index .......................................................................................................................... 229 Part I Basics in Tribology
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