Abstract
Cobalt-chromium-molybdenum alloy (CoCrMo) and ceramic are the two most common materials for the femoral head in hip joint prostheses, and the acetabular liner is typically made from ultra-high molecular weight polyethylene (UHMWPE), highly cross-linked polyethylene (XLPE), or highly cross-linked polyethylene blended with Vitamin E (VEXLPE). The selection of suitable materials should consider both wear performance and cost-effectiveness. This study compared the wear rate between different friction pairs using a hip joint simulator and then recommended a suitable prosthesis based on the corresponding processing technology and cost. All wear simulations were performed in accordance with ISO 14242, using the same hip joint simulator and same test conditions. This study found that when using the same material for the femoral head, the XLPE and VEXLPE liners had a lower wear rate than the UHMWPE liners, and the wear rate of the XLPE liners increased after blending with Vitamin E (VEXLPE). There was no significant difference in the wear rate of XLPE when using a CoCrMo or ceramic head. Considering the wear rate and cost-effectiveness, a CoCrMo femoral head with an accompanying XLPE liner is recommended as the more suitable combination for hip prostheses.
Highlights
Osteoarthritis (OA) is one of the most common diseases of the hip joint
The most widely used materials for the femoral head are cobalt-chromiummolybdenum alloy (CoCrMo) and ceramic, and the acetabular liner is typically made from ultra-high molecular weight polyethylene (UHMWPE), highly cross-linked polyethylene (XLPE), or highly cross-linked polyethylene blended with Vitamin E (VEXLPE) [8]
The results showed that the XLPE liner had a much lower mean wear rate (0.68 ± 0.11 mg/million cycles) than the UHMWPE liner
Summary
Osteoarthritis (OA) is one of the most common diseases of the hip joint. It is clinically characterized by joint pain, deformation, and restricted movement [1]. Postoperative complications after THA are common and can result in patient disability, implant failure, osteolysis, and prosthesis loosening [2]. It has been reported that over 50% of THA revisions are the result of implant loosening [3]. Wear particles generated between the femoral head and acetabular liner as the joint articulates are engulfed by macrophages to produce a large number of cytokines which activate osteoclasts and can cause osteolysis around the prosthesis, subsequently leading to prosthesis loosening [4,5]. The wear performance of the hip joint prostheses is critical for long-term implant survival [6,7]
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