Wear performance of large-diameter differential-hardness hip bearings.

We hypothesized that differential-hardness hard-on-hard bearings would generate less wear debris compared with like-hardness metal-on-metal (M-o-M) bearings. We conducted wear testing on 3 types of large-diameter hard hip bearings: (1) contemporary cast-on-cast ("like" hardness) M-o-M; (2) differential-hardness M-o-M; and (3) differential-hardness ceramic-on-metal. A simulated gait profile ranging from 200 to 2000 N was applied to the bearings at a frequency of 1 Hz for 5 Mc. All bearings were tested in an anatomically inverted position in 90% alpha calf serum. Both differential-hardness bearing systems produced lower run-in wear rates (90%-97%), steady-state wear rate (45%-84%), and total metal wear (68%-88%) compared with the like-hardness bearing system. The ceramic-on-metal bearings exhibited the least wear followed by differential-hardness M-o-M bearings; like-hardness M-o-M bearings exhibited the greatest amount of wear. These findings support our hypothesis that differential-hardness hip bearing systems produce less metallic wear debris than those with like hardness and may result in lower metal ion release in vivo.

[1]  J Fisher,et al.  A novel low wearing differential hardness, ceramic-on-metal hip joint prosthesis. , 2001, Journal of biomechanics.

[2]  D Dowson,et al.  A comparative joint simulator study of the wear of metal-on-metal and alternative material combinations in hip replacements , 2000, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[3]  P. Campbell,et al.  Cobalt and Chromium Concentrations in Patients With Metal on Metal Total Hip Replacements , 1996, Clinical orthopaedics and related research.

[4]  R. Chiesa,et al.  In vivo wear of three types of metal on metal hip prostheses during two decades of use. , 1996, Clinical orthopaedics and related research.

[5]  U. Wyss,et al.  Clinical Wear Performance of Metal-on-Metal Hip Arthroplasties , 1998 .

[6]  J Fisher,et al.  Quantitative analysis of wear and wear debris from metal-on-metal hip prostheses tested in a physiological hip joint simulator. , 2001, Bio-medical materials and engineering.

[7]  P. Paavolainen,et al.  Cancer incidence in Finnish hip replacement patients from 1980 to 1995: a nationwide cohort study involving 31,651 patients. , 1999, The Journal of arthroplasty.

[8]  Duncan Dowson,et al.  A hip joint simulator study of the performance of metal-on-metal joints: Part II: design. , 2004, The Journal of arthroplasty.

[9]  Duncan Dowson,et al.  A hip joint simulator study of the performance of metal-on-metal joints: Part I: the role of materials. , 2004, The Journal of arthroplasty.

[10]  J. Fisher,et al.  Metal-on-metal bearings surfaces: Materials, manufacture, design, optimization, and alternatives , 2006, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[11]  J. Black.  Systemic effects of biomaterials. , 1984, Biomaterials.

[12]  Michael Tanzer,et al.  The Otto Aufranc Award. Wear and lubrication of metal-on-metal hip implants. , 1999, Clinical orthopaedics and related research.