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

Clarke, Ian C.; Lazennec, Jean-Yves; Savisaar, Christina; Bowsher, John G.; Burgett, Michelle; Donaldson, Thomas

doi:10.1007/s11999-013-3399-3

Cited by 21 publications

(24 citation statements)

References 77 publications

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“…Similar shoulder formations were evident in MOM retrieval studies ( Figure 11). 1,13,30 The novel POD study 30 represented the only ''scratch-profiling'' of metal particles against metal substrates (Table 1). It was also very relevant because the 150 mm size steel beads had essentially the same size range as CoCr beads used in this simulator study (Tables 3 and 4).…”

Section: Discussionmentioning

confidence: 99%

“…Summary of abrasion studies using pin-on-disc (POD) wear machines and hip simulators (SIM). Lubricants have included bovine-serum [1][2][3] , distilled water 4 3), our hypotheses were that (a) PMMA particles would not be hard enough to scratch CoCr surfaces; (b) CoCr particles would both abrade and plow into CoCr surfaces, creating ''microgrooves'' (scratches . 40 mm wide); 13 and (c) Ti6Al4V particles would both scratch and smear onto CoCr surfaces, thereby creating diverse abrasion patterns.…”

Section: Introductionmentioning

confidence: 99%

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Profiling the third-body wear damage produced in CoCr surfaces by bone cement, CoCr, and Ti6Al4V debris: A 10-cycle metal-on-metal simulator test

Halim

Burgett

Donaldson

et al. 2014

Proc Inst Mech Eng H

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Particles of bone cement (polymethyl methacrylate), CoCr and Ti6Al4V were compared for their abrasion potential against CoCr substrates. This appears to be the first study utilizing CoCr and Ti6Al4V particulates to abrade CoCr bearings and the first study profiling the morphology of third-body abrasive wear scratches in a hip simulator. The 5 mg debris allotments (median size range 140-300 µm) were added to cups mounted both inverted and anatomically with metal-on-metal (MOM) bearings in a 10-cycle, hip simulator test. Surface abrasion was characterized by roughness indices and scratch profiles. Compared to third-body abrasion with metal debris, polymethyl methacrylate debris had minimal effect on the CoCr surfaces. In all, 10 cycles of abrasion with metal debris demonstrated that roughness indices (Ra, PV) increased approximately 20-fold from the unworn condition. The scratch profiles ranged 20-108 µm wide and 0.5-2.8 µm deep. The scratch aspect ratio (W/PV) averaged 0.03, and this very low ratio indicated that the 140 µm CoCr beads had plastically deformed to create wide but shallow scratches. There was no evidence of transfer of CoCr beads to CoCr bearings. The Ti64 particles produced similar scratch morphology with the same aspect ratio as the CoCr particulates. However, the titanium particulates also showed a unique ability to flatten and adhere to the CoCr, forming smears and islands of contaminating metal on the CoCr bearings. The morphology of scratches and metal transfer produced by these large metal particulates in the simulator appeared identical to those reported on retrieved metal-on-metal bearings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Profiling the third-body wear damage produced in CoCr surfaces by bone cement, CoCr, and Ti6Al4V debris: A 10-cycle metal-on-metal simulator test

Halim

Burgett

Donaldson

et al. 2014

Proc Inst Mech Eng H

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“…Hip impingement in particular represents an unavoidable and we believe a major clinical risk for production of large 3rd-body metal particulates. As illustrated (Figure 17), when the femoral implant of either CoCr or Ti6Al4V alloy can impact against the acetabular cup, the CoCr liner rim (Figure 17: #1) may notch the neck (Figure 17: #2), releasing either CoCr or Ti6Al4V particles [58,67,68]. The resulting destabilization of the hip-joint allows large hip muscles to force head rotation (or migration #3) over the cup rim (#4) during such episodes, creating large linear scratches on heads (#5) [58] and releasing large quantities of 3rd-body CoCr particles [58,69].…”

Section: Discussionmentioning

confidence: 99%

Acetabular Cups in 60 mm Metal-on-Metal Bearings Subjected to Dynamic Edge-Loading with 70° Peak-Inclination in 10-Million Cycle Simulator Study

Clarke

Halim²,

Smith

et al. 2017

Lubricants

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Wear simulation of total-hip arthroplasty (THA) involves hip biomechanics, tribology, bearing designs and cup wear-patterns. This is the first demonstration of cup edge-loading using the "Inverted-cup" test mode. Benefits included, (i) clinically relevant wear-patterns, and (ii) cup inclinations varying from ideal to edge-loaded during each 1-s simulator cycle. The 60 mm head and cup bearings in metal-on-metal (MOM) hip joints showed run-in and steady-state wear phases to 10-million cycles (Mc). MOM edge-wear was not unduly high at 1.7 mm 3 /Mc overall, this 3-fold higher than 60 mm MOM study without edge-loading. One MOM outlier averaged 2.7 mm 3 /Mc, this representing the break-away wear (BAW) phenomena. A surprising result was that cups contributed 75-93% of total wear. The most disturbing conclusion from review of laboratory studies was that MOM wear-rates varied 1 to >30 mm 3 /Mc for reasons not understood. These data suggested a new hypothesis, that MOM bearings were very sensitive to external stimuli, be they simulator artifact or patient related.

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“…3b). We applied this method to MOM retrieval studies to identify the wear patterns created in vivo and thereby deduce the implant orientations [31,35]. This also became a prerequisite for determining stripe wear locations produced on femoral heads, where the cups reached extremes of hip motion.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore this patient had experienced edge wear during gait and extensive cup thinning was evident, thought to be due to the repetitive subluxation of the femoral head during impingement. Thus there were multiple implant sites capable of releasing metal debris [35]. Trunnion fretting and corrosion aspects are not discussed here, being the subject of a follow-up paper.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Alignment of Main Wear-Pattern on MOM Total Hip Replacement

Paul

Medina²,

Burgett-Moreno³

et al. 2015

ReconRev

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In the majority of retrievals, femoral heads and cups are sent for analysis with no designation as to positioning in-vivo. In addition, when patients retain the femoral prosthesis, evidence of neck impingement damage is lost. In this case report we studied head and cup wear-patterns and stripe damage in a novel case that included a large diameter metal-on-metal THA that was retrieved with the head still fused to the stem. This provided anatomical positioning of head wear-pattern and stripe damage as represented by the orientation of the femoral stem in radiographic images. We investigated (1) size, shape and location of head and cup wear-patterns, (2) cup-to-stem impingement damage, and (3) head stripe-wear. The head wear-pattern was elliptical in shape, 40mm diameter with area covering 2200 sq.mm. Its hemispherical ratio was 56% with aspect ratio 1.2 and typical of large-diameter MOM retrievals. Wear-pattern extended from 12° above superior head-margin to approximately 40° inferior to polar axis. Centroidal vector in coronal plane was 13° posterior to polar axis and in transverse plane was 19° superior to polar axis. These vector data corresponded well with biomechanical predictions of resultant load axes in gait studies. Stripe damage was identified on the head, and the cup rim could thereby be aligned to verify neck impingement and also head subluxation mechanisms. Cup wear-pattern was not centrally contained, indicating this patient had experienced repetitive edge-wear during gait. Thinning of the cup rim by 350- 400µm indicated that posterior impingement with repetitive anterior subluxation of the head had created this edge-wear.

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

Cited by 21 publications

References 77 publications

Profiling the third-body wear damage produced in CoCr surfaces by bone cement, CoCr, and Ti6Al4V debris: A 10-cycle metal-on-metal simulator test

Profiling the third-body wear damage produced in CoCr surfaces by bone cement, CoCr, and Ti6Al4V debris: A 10-cycle metal-on-metal simulator test

Acetabular Cups in 60 mm Metal-on-Metal Bearings Subjected to Dynamic Edge-Loading with 70° Peak-Inclination in 10-Million Cycle Simulator Study

Biomechanical Alignment of Main Wear-Pattern on MOM Total Hip Replacement

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