Abstract

Several retrieval studies have reported on metallic depositions on ceramic femoral heads, but the effect on the wear behavior of artificial hip joints has not been investigated in wear simulator studies. In the present study, retrieved ceramic heads with metallic depositions as third particles were tested against cross-linked ultra-high-molecular-weight polyethylene (UHMWPE) liners in a hip wear simulator. The amount of liner wear and expansion of metallic depositions on the heads were determined before and after wear testing with digital microscopy. The surface roughness of the heads was investigated in areas with and without metallic depositions by laser scanning microscopy. After five million load cycles, a non-significant reduction in the metallic formation on the retrieved heads was found. The metallic areas showed a higher surface roughness compared to unconcerned areas. The liners showed a higher wear rate of 1.57 ± 1.36 mg/million cycles for 28 mm heads and 2.42 ± 0.82 mg/million cycles for 36 mm heads with metallic depositions, in comparison with new ceramic heads with a 28 mm size ((−0.06 ± 0.89) mg/million cycles) and 36 mm size ((2.04 ± 0.46) mg/million cycles). Metallic transfer on ceramic heads can lead to an increased surface roughness and higher wear rates at the UHMWPE liners. Therefore, metallic contact of the ceramic femoral head should be avoided.

Highlights

  • The main cause of total hip revision is aseptic loosening caused by wear particles [1,2]

  • Metallic transfer on ceramic heads can lead to an increased surface roughness and higher wear rates at the ultra-high-molecular-weight polyethylene (UHMWPE) liners

  • The aim of the present study was to determine the influence of metallic depositions on ceramic femoral heads on the wear behavior of ceramic-on-PE bearings under standardized test conditions using a hip wear simulator

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Summary

Introduction

The main cause of total hip revision is aseptic loosening caused by wear particles [1,2]. In retrieval studies of ceramic femoral heads, authors have reported dark shiny metallic formations on the surface, mainly at the equator of the head [2,3,11,12], due to the transfer of metallic material to the surface of the ceramic head [11,12,13,14,15]. Such formations were described in a simulator study during the testing of ceramic-on-metal bearings [13,16] and they can appear linear and planar. Most studies indicate that metallic transfer is caused by the malpositioning, loosening, or dislocation of implant

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