Abstract

A previous retrieval study analyzed the backside wear of short-term implanted liners against in vitro tested liners of similar life in service and showed comparable results among both groups, with no significant backside wear due to micro-motion.The purpose — to obtain a picture of the overall wear (articulation and backside surfaces) of 0.1% vitamin e blended polyethylene liners, with a locking mechanism based on a press-fit cone in combination with a rough titanium conical inner surface in the fixation area, under a 20 million cycles hip wear simulation.Materials and Methods. A semi-quantitative method was used in order to assess the damage on the backside of the liners and a 3d measuring machine to assess the creep and wear at the articulation surface.Results. The total average backside wear score was 22.00±2.59 from a maximum total score of 147 after 5 million cycles (mc), increased to 31.92±5.57 after 10 mc, but showed no further increment after 15 and 20 mc. The reference liners (subjected only to axial load) showed similar wear scores and modes as the liners under wear simulation (axial load and movement). Small scratches produced during insertion and removal were clearly seen at the rim (fixation) area and no considerable abrasion was observed. The machining marks on the convex surface were always visible. Regarding the articulation surface, a steady state wear rate of 7 µm/year was measured.Conlusion. These results determined that most of the backside wear produced on the liners occurred during their insertion and removal rather than during their life in service. Moreover, the wear at the articulation surface was similar to that seen in vivo at short- and mid-term on highly cross-linked polyethylene liners with and without vitamin e content.

Highlights

  • Aseptic loosening as a consequence of wear generated particulate debris remains the principal reason for revision in total hip arthroplasty at the long-term [1]

  • The wear produced at the interface between the liner and the metallic acetabular component, known as backside wear, gained importance after high revision rates due to retroacetabular osteolysis were seen on retrieved liners showing high backside wear [2,3,4,5,6]

  • A previous retrieval study analyzed the backside wear of acetabular liners with a locking mechanism based on a press-fit cone with a large surface area in combination with a grit blasted rough titanium inner surface along the rim of the acetabular shell [11]

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Summary

Introduction

Aseptic loosening as a consequence of wear generated particulate debris remains the principal reason for revision in total hip arthroplasty at the long-term [1]. When there is an unstable locking mechanism and a poor conformity between the liner and the acetabular shell, wear is produced at this non-articulating surface as a result of micro-motions between both components [7,8,9]. A previous retrieval study analyzed the backside wear of acetabular liners with a locking mechanism based on a press-fit cone with a large surface area in combination with a grit blasted rough titanium inner surface along the rim of the acetabular shell [11]. The backside wear of short-term retrievals made out of conventional standard polyethylene (CPE), highly cross-linked polyethylene (XLPE) and highly crosslinked and vitamin E (0.1%) blended polyethylene was analyzed and compared with their corresponding in vitro tested liners of equivalent life in service, showing similar results among both groups and no significant backside wear due to micro-motion

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