Transfer of metallic debris after dislocation of ceramic femoral heads in hip prostheses

Müller, Frank A.; Hagymási, Marcel; Greil, Peter; Zeiler, Günther; Schuh, Alexander

doi:10.1007/s00402-006-0109-6

Cited by 26 publications

(25 citation statements)

References 19 publications

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“…How well the transfer adheres to the femoral head and maintains its roughness during subsequent articulation is likely to affect the long-term wear rates and may depend upon the femoral head material. While Ti transfer may abrade away in ceramic-on-ceramic heads, such transfer retains its increased roughness in ceramic-on-polyethylene devices accelerating polyethylene wear [13]. While Schuh et al [10] reported no adherent Ti on a scratched CoCr retrieval, the present results suggested that titanium may remain adherent to CoCr and zirconia surfaces in contact with polyethylene counterfaces, thereby increasing surface roughness and potentially increasing polyethylene wear.…”

Section: Discussionmentioning

confidence: 58%

“…In either case, Ti or CoCr may transfer to the surface of the harder femoral head material and increase its roughness, leading to increased severe scratching and abrasive wear of polyethylene [9–12]. Müller et al [13] reported that Ti transfer was abraded away in ceramic-on-ceramic heads; however, for alumina-on-polyethylene it was suggested that the transfer was “more harmful,” retaining its increased roughness and accelerating polyethylene wear. …”

Section: Introductionmentioning

confidence: 99%

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Surface Roughness of CoCr and ZrO₂ Femoral Heads with Metal Transfer: A Retrieval and Wear Simulator Study

Eberhardt

McKee

Cuckler³

et al. 2009

International Journal of Biomaterials

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Metal transfer to femoral heads may result from impingement against the metallic acetabular shell following subluxation/dislocation, or when metallic debris enters the articulation zone. Such transfers roughen the head surface, increasing polyethylene wear in total hip replacements. Presently, we examined the surface roughness of retrieved femoral heads with metallic transfer. Profilometry revealed roughness averages in regions of metal transfer averaging 0.380 μm for CoCr and 0.294 μm for ZrO2 which were one order of magnitude higher than those from non-implanted controls. Scanning electron microscopy (SEM) revealed adherent transfers on these retrievals, with titanium presence confirmed by electron dispersive spectroscopy. Due to the concern for increased wear, metal transfer was induced on non-implanted heads, which were then articulated against flat polyethylene discs in multidirectional sliding wear tests. Increased polyethylene wear was associated with these specimens as compared to unaltered controls. SEM imaging provided visual evidence that the transfers remained adherent following the wear tests. Pre- and post-test roughness averages exceeded 1 μm for both the CoCr and ZrO2 heads. Overall, these results suggest that metal transfer increases the surface roughness of CoCr and ZrO2 femoral heads and that the transfers may remain adherent following articulation against polyethylene, leading to increased polyethylene wear.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Surface Roughness of CoCr and ZrO₂ Femoral Heads with Metal Transfer: A Retrieval and Wear Simulator Study

Eberhardt

McKee

Cuckler³

et al. 2009

International Journal of Biomaterials

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“…It is possible that bearing damage could have been produced either by THA dislocation or alternatively by instruments used at revision surgery [8,30,60]. Ti6Al4V transfer onto CoCr surfaces could also be anticipated given the deep notching seen in titanium alloy necks in this study.…”

Section: Discussionmentioning

confidence: 98%

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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“…Also, the measured direction-dependence of wear for these relatively severe scratches is not necessarily representative of that for smaller/milder scratches, where different mechanisms for wear particle liberation might be operative. Similarly, the present directional relationships are not necessarily representative of those for yet larger-size macro-scratching damage, such as occurs in situations of dislocation or forced relocation [30,31]. Factors governing wear rate acceleration from macro-damage presently are not well understood, but presumably the interplay between macro-scratch location, macro-scratch orientation, and articulation kinematics and kinetics is a major consideration.…”

Section: Discussionmentioning

confidence: 97%

Sliding Direction Dependence of Polyethylene Wear for Metal Counterface Traverse of Severe Scratches

Glennon

Baer

Martin

et al. 2008

Journal of Biomechanical Engineering

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Third body effects appear to be responsible for an appreciable portion of the wear rate variability within cohorts of patients with metal-on-polyethylene joint replacements. The parameters dominating the rate of polyethylene debris liberation by counterface scratches are not fully understood, but one seemingly contributory factor is the scratch's orientation relative to the direction of instantaneous local surface sliding. To study this influence, arrays of 550 straight parallel scratches each representative of the severe end of the clinical range were diamond stylus-ruled onto the surface of polished stainless steel plates. These ruled plates were then worn reciprocally against polyethylene pins (both conventional and highly cross-linked) at traverse angles varied parametrically relative to the scratch direction. Wear was measured gravimetrically, and particulate debris was harvested and morphologically characterized. Both of the polyethylene variants tested showed pronounced wear rate peaks at acute scratch traverse angles (15º for conventional, 5º for cross-linked), and had nominally comparable absolute wear rate magnitudes. The particulate debris from this very aggressive test regime primarily consisted of extremely large and elongated strands, often tens or even hundreds of microns in length. These data suggest that counterface damage regions with preferential scratch directionality can liberate large amounts of polyethylene debris, apparently by a slicing/shearing mechanism, at critical (acute) attack angles. However, the predominant manifestation of this wear volume was in the form of particles far beyond the most osteolytically potent size range.

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Transfer of metallic debris after dislocation of ceramic femoral heads in hip prostheses

Cited by 26 publications

References 19 publications

Surface Roughness of CoCr and ZrO₂ Femoral Heads with Metal Transfer: A Retrieval and Wear Simulator Study

Surface Roughness of CoCr and ZrO₂ Femoral Heads with Metal Transfer: A Retrieval and Wear Simulator Study

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

Sliding Direction Dependence of Polyethylene Wear for Metal Counterface Traverse of Severe Scratches

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Transfer of metallic debris after dislocation of ceramic femoral heads in hip prostheses

Cited by 26 publications

References 19 publications

Surface Roughness of CoCr and ZrO2 Femoral Heads with Metal Transfer: A Retrieval and Wear Simulator Study

Surface Roughness of CoCr and ZrO2 Femoral Heads with Metal Transfer: A Retrieval and Wear Simulator Study

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

Sliding Direction Dependence of Polyethylene Wear for Metal Counterface Traverse of Severe Scratches

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Product

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Surface Roughness of CoCr and ZrO₂ Femoral Heads with Metal Transfer: A Retrieval and Wear Simulator Study

Surface Roughness of CoCr and ZrO₂ Femoral Heads with Metal Transfer: A Retrieval and Wear Simulator Study