Fretting Corrosion and Trunnion Wear—Is it Also a Problem for Sleeved Ceramic Heads?

Preuss, Roman; Haeussler, K; Flohr, Markus; Streicher, Robert

doi:10.1053/j.sart.2013.01.008

Cited by 19 publications

(17 citation statements)

References 19 publications

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“…In our series, periprosthetic osteolysis was detected in 1.1% (three of 274 hips), but none of these hips showed any pain or any signs of infection. Although we did not record the levels of metal ions or revise the hips with osteolysis, a recent in vitro study has demonstrated that a large ceramic head with a metal sleeve does not have an effect on the corrosion between the metal sleeve and the metal taper [24]. It is currently unclear whether there is fretting corrosion and trunnion wear in a sleeved ceramic head in vivo.…”

Section: Discussionmentioning

confidence: 91%

Primary Ceramic-on-ceramic Total Hip Arthroplasty Using a 32-mm Ceramic Head With a Titanium-alloy Sleeve

Lim

Jang

Kim

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Modern ceramic-on-ceramic bearings have become attractive alternatives to conventional polyethylene in total hip arthroplasty (THA) as a result of their low wear and minimal particle production. However, 28-mm heads in ceramic-on-ceramic bearing couples have been associated with ceramic fracture. To address these issues, 32-mm and larger ceramic heads with a titanium-alloy sleeve have been introduced, although limited data are available on their durability and clinical outcomes. Questions/purposes We determined (1) the survivorship of the primary ceramic-on-ceramic THA using a 32-mm ceramic head with a titanium-alloy sleeve at a minimum followup of 5 years; (2) Harris hip scores; (3) the incidence of ceramic fracture and noisy hip; and (4) the proportion of hips showing radiographic evidence of osteolysis. Methods From November 2005 to August 2009, we performed 301 ceramic-on-ceramic THAs using a 32-mm ceramic head with a titanium-alloy sleeve in 270 patients. Of these, 12 patients (12 hips [4%]) died from problems unrelated to surgery and 13 patients (15 hips [5%]) were lost during followup before a minimum of 5 years had been reached, leaving 245 patients who had 274 THAs with a minimum followup of 5 years (mean, 6.5 years; range, 5-9 years) in this retrospective analysis. During the study period, 30% (301 of 997 hips) were performed with this articulation based on the operating surgeon's discretion. The mean patient age at the time of surgery was 55 years (range, 16-82 years). All operations were performed at a single center. All of the ceramic implants were hot isostatic-pressed, laser-marked, proof-tested third-generation alumina. We determined the implant survival, Harris hip scores, incidence of ceramic fracture or noisy hips (based on a questionnaire), and presence of osteolysis. Results The survival rate of ceramic-on-ceramic bearings in primary THA using a 32-mm ceramic head with a titanium-alloy sleeve was 98% (95% confidence interval, 96%-100%) at 9 years. The Harris hip score improved from a mean of 47 points preoperatively to 93 points at last followup. One ceramic head fractured at 6 years postoperatively. No ceramic liners fractured. Audible hip clicking and squeaking were identified in four hips and one hip, respectively. Osteolysis was detected in three hips, but none had symptoms. Conclusions Primary ceramic-on-ceramic THA using a 32-mm ceramic head with a titanium-alloy sleeve has a survivorship of 98% at 9-year followup. Nevertheless, surgeons should be aware of the potential risks of ceramic

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Section: Discussionmentioning

confidence: 91%

Primary Ceramic-on-ceramic Total Hip Arthroplasty Using a 32-mm Ceramic Head With a Titanium-alloy Sleeve

Lim

Jang

Kim

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…The results have highlighted that the amount of material loss from stem tapers is considerably lower compared to the head tapers in the cohort suggesting preferential material loss is occurring. Published in vitro studies [24][25][26] suggest that the same pattern of preferential material loss and imprinting especially in the cases of stems that present a highly anisotropic surface topography.…”

Section: Discussionmentioning

confidence: 99%

Method for Characterization of Material Loss from Modular Head-Stem Taper Surfaces of Hip Replacement Devices

Răcăşăn

Bills

Blunt

et al. 2015

Modularity and Tapers in Total Joint Replacement Devices

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Assessment of the head-stem taper junction requires the estimation of material loss from the taper surfaces of both femoral head and stem. This paper describes a method for the measurement and analysis of material loss from the modular taper junction of hip replacements, in particular femoral stem tapers where generally the entire taper surface has been engaged. In such cases no direct unengaged datum surface is readily identifiable to assess material loss. The highly anisotropic topology of some stem designs poses additional challenges to the measurement and analysis process. Estimation of material loss of retrieved femoral stems is further complicated by retrieval damage or surface deposits often present on the taper surface. The femoral head tapers typically exhibit areas of pristine surface attributed to the difference in taper length compared to the engaging stem. These areas can be selected as unworn when employed in the analysis process, provided they do not show surface damage or deposits. Measurement of the taper surfaces has been performed using a Talyrond (Ametek, Inc., US) outof-roundness measurement instrument equipped with a 5µm diamond tip stylus. Vertical axial traces were employed to digitize the surface of the taper. Measurement data has been analyzed using a multi stage process that has been specifically adapted for stem tapers. The underlying stem taper geometry is determined by means of a morphological filter applied to the high aspect ratio microstructure. This paper presents a study of 40 retrieved LHMoM hip replacements that have been analyzed to ascertain the material loss at the modular taper junction. The purpose of this study was to ascertain the viability of characterizing material loss from the stem taper junction and to provide insight into the overall material loss contribution.

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“…A large number of factors have been identified as possible contributors to the observed material loss including micromotion due to angle mismatch, insufficient assembly forces, galvanic cell creation due to differential head and stem materials and increased frictional torque [12][13][14][15][16]. Determination of the volume of material loss at this interface is vital in determining the relative contribution that this makes to the overall failure of metal-on-metal hip bearings [18][19][20][21][22][23][24][25]. Most previous studies relied on either the visual assessment of taper damage (which can be clearly seen in figure 2) or measurement by means of coordinate measuring machines [5,10].…”

Section: Figurementioning

confidence: 99%

Assessing the material loss of the modular taper interface in retrieved metal-on-metal hip replacements

Bills

Răcăşăn

Tessier

et al. 2015

Surf. Topogr.: Metrol. Prop.

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Abstract. Measuring the amount of material loss in the case of revised hip replacements is considered to be a prerequisite of understanding and assessing the true in vivo performance of the implant. This paper outlines a method developed by the authors for quantifying taper material loss as well as more general taper interface parameters. Previous studies have mostly relied on visual inspection to assess the material loss at the taper interface, whereas this method aims to characterize any surface and form changes through the use of an out-of-roundness measurement machine. Along with assessing the volumetric wear, maximum linear penetration and taper contact length can also be determined. The method was applied to retrieved large head metal-on-metal femoral heads in order to quantify the material loss at this junction. Material loss from the female femoral head taper can be characterized as a localized area that is in contact with the stem taper surface. The study showed that this method has good repeatability and a low level of interoperability variation between operators.

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Fretting Corrosion and Trunnion Wear—Is it Also a Problem for Sleeved Ceramic Heads?

Cited by 19 publications

References 19 publications

Primary Ceramic-on-ceramic Total Hip Arthroplasty Using a 32-mm Ceramic Head With a Titanium-alloy Sleeve

Primary Ceramic-on-ceramic Total Hip Arthroplasty Using a 32-mm Ceramic Head With a Titanium-alloy Sleeve

Method for Characterization of Material Loss from Modular Head-Stem Taper Surfaces of Hip Replacement Devices

Assessing the material loss of the modular taper interface in retrieved metal-on-metal hip replacements

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