Metal-on-metal vs. metal-on-polyethylene total hip arthroplasty tribological evaluation of retrieved components and periprosthetic tissue.
Metal-on-metal vs. metal-on-polyethylene total hip arthroplasty tribological evaluation of retrieved components and periprosthetic tissue.
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DOI：
10.1016/j.jmbbm.2014.02.018
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发表时间：
2014-06
影响因子：
3.9
通讯作者：
Matevž Topolovec;A. Cör;I. Milošev
中科院分区：
文献类型：
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作者：
Matevž Topolovec;A. Cör;I. Milošev
背景和目的金属对金属（MoM）关节面是传统金属对聚乙烯（MoP）关节面的替代品，可减少磨损并提高髋关节假体的存活率。本研究的目的是比较摩擦学性能和评价perisprosthetic组织反应，在两个相同的假体组不同的只是在bearing.Patients和methodsAt类型的翻修手术26 MoM和12 MoP轴承组件和perisprosthetic组织样本进行了收集。使用假体组件评估磨损损伤、线性和体积磨损以及粗糙度。假体周围组织样本用于组织学以及免疫组化分析和隔离和表征的磨损particles.ResultsThe平均线性磨损率在MoM组为2.34（SD 1.93）μm/年，显着低于值在MoP组，11.52（SD 7.82）μm/年。体积磨损也显著较低，MoM为0.19（SD 0.32）mm 3/年，而MoP为0.98（SD 0.78）mm 3/年。在两组中，主要磨损模式均为磨粒磨损。MoM组的组织学结果表明，与MoP组相比，更多的淋巴细胞主导的假体周围组织反应。MoP组中聚乙烯颗粒的平均尺寸为0.21（SD 0.44）µm。在MoM中，确定了纳米尺寸的CoCrMo颗粒。金属颗粒的表征是复杂的，需要在仪器方面特别注意（背散射模式的场发射扫描电子显微镜）;结论尽管MoM组磨损明显较低，因此磨损颗粒对假体周围组织的负荷较小，但组织反应相似，如果不比MoP组更强烈的话。
Background and purposeMetal-on-metal (MoM) bearings were introduced as an alternative to conventional metal-on-polyethylene (MoP) bearings to reduce the wear and to increase the survival of hip prostheses. The goal of the present study was to compare tribological properties and to evaluate periprosthetic tissue reaction in two identical groups of prostheses differing only in the type of bearings.Patients and methodsAt revision operations 26 MoM and 12 MoP bearing components and perisprosthetic tissue samples were collected. Prosthetic components were used to assess wear damage, linear and volumetric wear and roughness. Periprosthetic tissue samples were used for histological as well as immunohistochemical analysis and isolation and characterization of wear particles.ResultsThe mean linear wear rate in the MoM group was 2.34 (SD 1.93) μm/year, significantly lower than the value in the MoP group, 11.52 (SD 7.82) μm/year. Significantly lower was also the volumetric wear, 0.19 (SD 0.32) mm3/year for MoM compared to 0.98 (SD 0.78) mm3/year for MoP. In both groups the main wear mode was abrasive wear. Histological results for MoM group indicate more lymphocyte dominated periprosthetic tissue reaction compared to MoP group. The mean size of polyethylene particles in the MoP group was 0.21 (SD 0.44) µm. In the MoM nanosized CoCrMo particles were identified. The characterization of metal particles was complex and required special attention in terms of instrumentation (field emission scanning electron microscopy in back-scattered mode); otherwise it was difficult to distinguish metal particles from other particles in the tissue.ConclusionsDespite a significantly lower wear and, consequently, smaller load of periprosthetic tissue with wear particles in the MoM group, the tissue reaction was similar, if not more intense than in the MoP group.