Tribology of total hip arthroplasty prostheses

Rieker, C

doi:10.1302/2058-5241.1.000004

Cited by 25 publications

(13 citation statements)

References 53 publications

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“…Given their now known higher failure rates, THAs with a MoM bearing surface were excluded (n = 5,359) (Drummond et al. 2015 , Nederlandse Orthopaedische Vereniging 2015 , Rieker 2017 ). Patients with unknown prosthesis components or patients for whom 1 of the components was not registered were excluded (n = 11,836).…”

Section: Methodsmentioning

confidence: 99%

The effect of bearing type on the outcome of total hip arthroplasty

et al. 2017

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Background and purposeAlternative bearing surfaces such as ceramics and highly crosslinked polyethylene (HXLPE) were developed in order to further improve implant performance of total hip arthroplasties (THAs). Whether these alternative bearing surfaces result in increased longevity is subject to debate.Patients and methodsUsing the Dutch Arthroplasty Register (LROI), we identified all patients with a primary, non-metal-on-metal THA implanted in the Netherlands in the period 2007–2016 (n = 209,912). Cumulative incidence of revision was calculated to determine differences in survivorship of THAs according to bearing type: metal-on-polyethylene (MoPE), metal-on-HXLPE (MoHXLPE), ceramic-on-polyethylene (CoPE), ceramic-on-HXLPE (CoHXLPE), ceramic-on-ceramic (CoC), and oxidized-zirconium-on-(HXL)polyethylene (Ox(HXL)PE). Multivariable Cox proportional hazard regression ratios (HRs) were used for comparisons.ResultsAfter adjustment for confounders, CoHXLPE, CoC, and Ox(HXL)PE resulted in a statistically significantly lower risk of revision compared with MoPE after 9 years follow-up (HR =0.8–0.9 respectively, compared with HR =1.0). For small (22–28 mm) femoral head THAs, lower revision rates were found for CoPE and CoHXLPE (HR =0.9). In the 36 mm femoral head subgroup, CoC-bearing THAs had a lower HR compared with MoHXLPE (HR =0.7 versus 1.0). Crude revision rates in young patients (< 60 years) for CoHXLPE, CoC, and Ox(HXL)PE (HR =0.7) were lower than MoPE (HR =1.0). However, after adjustment for case mix and confounders these differences were not statistically significant.InterpretationWe found a mid-term lower risk of revision for CoHXLPE, CoC, and Ox(HXL)PE bearings compared with traditional MoPE-bearing surfaces.

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Section: Methodsmentioning

confidence: 99%

The effect of bearing type on the outcome of total hip arthroplasty

et al. 2017

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“…The biomaterial susceptibility of both metal and polyethylene to wear and osteolysis, however, limited their survival, and as such, precipitated the development of alternative articulating surfaces [ 8 ]. Ceramic bearings were thus developed, with their theoretically favorable wear and osteolytic properties when compared to MoP resulting in relatively high survival rates [ 5 , 6 ], thus making them a viable articular option during THA [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…With this in mind, the utilization of ceramic articular bearings has become increasingly prevalent due to their favorable biomaterial properties [ 5 ]. Ceramic bearings display a high Young’s Modulus and are both biocompatible and bioinert [ 6 ]. Furthermore, modern articulating ceramics are both scratch-resistant and wettable and thus are thought to have extremely amenable wear and osteolytic-resistant characteristics, with the survival of up to 84.4% at 21 years described [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Despite these features, ceramic bearings remain at risk of failure, having traditionally been susceptible to brittle fracture due to their high notch sensitivity [ 6 ], particularly in early generation ceramics [ 5 ]. While the risk of this substantially reduced in modern ceramic bearings [ 2 ], component failure through this method, as well as complications such as squeaking, continues to exist [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Mode I and II Wear in Ceramic on Ceramic Total Hip Arthroplasty: A Case Report

Mohan¹,

McGoldrick²,

O’Driscoll³

et al. 2021

JOCR

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Introduction: Elective total hip arthroplasty (THA) is a common procedure and has been associated with favorable outcomes in both elderly and younger patients. A variety of implant and articular components exist so to allow surgeons to make a patient-specific choice with the intent of maximizing both patient outcomes and implant survival. The utilization of ceramic bearing surfaces during THA has become increasingly prevalent, with their tribological profile conveying favorable wear and osteolysis-resistant properties. Typically, ceramic articulating components are most susceptible to failure through brittle fracture or complications such as squeaking. Case Report: This case describes a 68-year-old Caucasian male who underwent revision of ceramic on ceramic THA due to pain, with intraoperative analysis revealing evidence of gross Mode I acetabular ceramic component wear with a resultant Mode II wear articulation between the ceramic femoral head and acetabular liner. Conclusion: Wear between ceramic implants in THA is infrequently reported, and as such awareness of this uncommon phenomena as well as its potential causative factors is important when considering either primary or revision THA involving ceramic bearing components. Keywords: Hip, arthroplasty, revision, ceramic, wear.

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“…On the other hand, over the last decades, there have been many advances in the fields of biomechanics, tribology, prosthetic design, and surgical technique [ 5 , 6 ] that have contributed to minimize the patient discomfort after arthroplasty favoring the reduction of the hospital recovery [ 7 ]. Moreover, in a climate of limited resources and global financial strain, ways of containing costs and pressure from third-party payers, maintaining at the same time highly efficient care pathways, better patient satisfaction, and improved patient-reported outcomes are needed [ 2 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of a fast track protocol and standard care after hip arthroplasty in the reduction of the length of stay and the early weight-bearing resumption: study protocol for a randomized controlled trial

Rocchi

Stagni

Govoni

et al. 2021

Trials

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Background To date, hip arthroplasty is one of the most commonly performed surgical procedures, with growing worldwide demand. In recent decades, major progress made in terms of surgical technique, biomechanics, and tribology knowledge has contributed to improve the medical and functional management of the patient. This study aims to assess if the application of a fast track protocol, consisting of a preoperative educational intervention, adequate postoperative pain control, and intensive rehabilitation intervention, reduces the length of stay (LOS) and allows the early functional recovery compared to standard clinical practice for patients undergoing hip arthroplasty. Methods The study population consists of 90 patients with primary arthrosis of the hip with an anterior indication of hip arthroplasty. The exclusion criteria are older than 70 years, a contraindication to performing spinal anesthesia, and bone mass index (BMI) greater than 32. Participants, 45 for each group, are randomly allocated to one of two arms: fast track clinical pathway or standard care protocol. During allocation, baseline parameters such as Harris Hip Score (HHS) and Western Ontario and McMaster Universities (WOMAC) index are collected. On the third postoperative day, the functional autonomy for each patient is assessed by the Iowa Level of Assistance (ILOA) scale, and it is expected the discharge for patients in the fast track group (primary outcome). On the other hand, standard care patient discharge is expected after 5–7 days after surgery. During follow-up fixed at 6 weeks and 3, 6, and 12 months, HHS and WOMAC scores are collected for each patient (secondary outcomes). Discussion Although total hip replacement has become a widespread standardized procedure, to the authors’ knowledge, only few randomized controlled trials were performed to evaluate the effectiveness of fast track pathway vs. standard care procedure in the reduction of the LOS after hip arthroplasty. It is expected that our results collected by the application of minimally invasive surgical interventions with concomitant management of perioperative pain and bleeding and early functional rehabilitation will contribute to enriching the understanding of clinical and organizational aspects linked to fast track arthroplasty. Trial registration ClinicalTrials.gov NCT03875976. Registered on 15 March 2019—“retrospectively registered”.

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Tribology of total hip arthroplasty prostheses

Cited by 25 publications

References 53 publications

The effect of bearing type on the outcome of total hip arthroplasty

The effect of bearing type on the outcome of total hip arthroplasty

Mode I and II Wear in Ceramic on Ceramic Total Hip Arthroplasty: A Case Report

Comparison of a fast track protocol and standard care after hip arthroplasty in the reduction of the length of stay and the early weight-bearing resumption: study protocol for a randomized controlled trial

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