Volumetric wear assessment of failed metal-on-metal hip resurfacing prostheses
Volumetric wear assessment of failed metal-on-metal hip resurfacing prostheses
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DOI：
10.1016/j.wear.2011.07.009
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发表时间：
2011-10-03
期刊：
影响因子：
5
通讯作者：
Joyce, T. J.
中科院分区：
文献类型：
--
作者：
Lord, J. K.;Langton, D. J.;Joyce, T. J.
髋关节置换术的最新进展使该手术具有良好的效果和高生存率。然而，故障仍然发生，主要原因是磨损碎屑引起的并发症。因此，必须通过减少轴承表面的磨损来最大限度地减少碎屑。一种建议的实现这种磨损减少的方法是通过使用金属对金属关节。这种生物材料组合的最新表现之一是髋关节表面置换的设计，其针对的是可能磨损传统金属对聚合物髋关节假体的更年轻、更活跃的患者。然而，这些金属对金属髋关节表面置换术植入患者体内时磨损是否更少？使用坐标测量机和定制的计算机程序，对取出的关节面置换（ASR（TM），DePuy）金属对金属髋关节表面置换进行体积磨损测量。测量了32个股骨头和22个髋臼杯。髋臼杯的平均体积磨损为29.00 mm（3）（范围1.35-109.72 mm（3）），磨损率为11.02 mm（3）/年（范围0.30-63.59 mm（3）/年）。股骨头的平均磨损为22.41 mm（3）（范围0.72-134.22 mm（3）），磨损率为8.72 mm（3）/年（范围0.21-31.91 mm（3）/年）。在22例来自同一假体的股骨头和髋臼杯均可用的病例中，观察到平均总磨损率为21.66 mm（3）/年（范围为0.51-95.50 mm（3）/年）。与许多体外试验相比，这些值明显高于功能良好的金属对金属髋关节表面置换假体的预期值，值得关注。(C)2011 Elsevier B. V.保留所有权利。
Recent advancements in hip arthroplasty have allowed the operation to boast excellent results and high survivorship. However, failures do still occur and a major cause is complications arising from wear debris. It is essential therefore that debris is minimized by reducing wear at the bearing surface. One proposed method of achieving this wear reduction is through the use of metal-on-metal articulations. One of the latest manifestations of this biomaterial combination is in designs of hip resurfacing which are aimed at younger, more active patients who might wear out a conventional metal-on-polymer hip prosthesis. However, do these metal-on-metal hip resurfacings show less wear when implanted into patients?Using a co-ordinate measuring machine and a bespoke computer program, volumetric wear measurements for retrieved Articular Surface Replacements (ASR (TM), DePuy) metal-on-metal hip resurfacings were undertaken. Thirty-two femoral heads and twenty-two acetabular cups were measured. Acetabular cups exhibited mean volumetric wear of 29.00 mm(3) (range 1.35-109.72 mm(3)) and a wear rate of 11.02 mm(3)/year (range 0.30-63.59 mm(3)/year). Femoral heads exhibited mean wear of 22.41 mm(3) (range 0.72-134.22 mm(3)) and a wear rate of 8.72 mm(3)/year (range 0.21-31.91 mm(3)/year). In the 22 cases where both head and cup from the same prosthesis were available, mean total wear rates of 21.66 mm(3)/year (range 0.51-95.50 mm(3)/year) were observed. Compared with in many vitro tests, these are significantly higher than those expected in a well functioning metal-on-metal hip resurfacing prosthesis and are of concern. (C) 2011 Elsevier B.V. All rights reserved.