Oxidized Zirconium Components Maintain a Smooth Articular Surface Except Following Hip Dislocation
| Autor: | Michael D. Ries, Douglas W. Van Citters, Noah Bonnheim, Lisa A. Pruitt |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_treatment Arthroplasty Replacement Hip Total hip replacement chemistry.chemical_element Prosthesis Design 03 medical and health sciences 0302 clinical medicine medicine Metal substrate Hip Dislocation Humans Orthopedics and Sports Medicine 030222 orthopedics Zirconium Articular surfaces business.industry Articular surface Arthroplasty Prosthesis Failure chemistry Oxinium Chromium Alloys Hip Prosthesis Dislocation business Biomedical engineering |
| Zdroj: | The Journal of arthroplasty. 36(4) |
| ISSN: | 1532-8406 |
| Popis: | Background Oxidized zirconium (OxZr) offers theoretical advantages in total hip and knee arthroplasty (THA and TKA, respectively) relative to other biomaterials by combining the tribological benefits of ceramics with the fracture toughness of metals. Yet, some studies have found that OxZr does not improve outcomes or wear rates relative to traditional bearing materials such as cobalt-chromium (CoCr). Separately, effacement of the thin ceramic surface layer has been reported for OxZr components, though the prevalence and sequelae are unclear. Methods To elucidate the in vivo behavior of OxZr implants, the articular surfaces of 94 retrieved THA and TKA femoral components (43 OxZr TKA, 21 OxZr THA, 30 CoCr THA) were analyzed using optical microscopy, non-contact profilometry, and scanning electron microscopy. Results We found that OxZr components maintain a smooth articular surface except following hip dislocation. Three of four OxZr femoral heads revised following dislocation exhibited severe damage to the articular surface, including macroscopic regions of ceramic-layer effacement and exposure of the underlying metal substrate; these components were 23-32 times rougher than pristine OxZr controls. When revised for dislocation, OxZr femoral heads were substantially rougher than CoCr femoral heads (median Sa = 0.431 v. 0.020 μm, P = .03). In contrast, CoCr femoral heads exhibited low overall roughness values regardless of whether they dislocated (median Sa = 0.020 v. 0.008 μm, P = .09, CoCr dislocators v. non-dislocators). Conclusions Effacement of the ceramic surface layer and substantial articular surface roughening is not atypical following dislocation of OxZr femoral heads, making OxZr much less tolerant than CoCr to hip dislocation. |
| Databáze: | OpenAIRE |
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