Failure analysis of sandwich-type ceramic-on-ceramic hip joints: A spectroscopic investigation into the role of the polyethylene shell component
Failure analysis of sandwich-type ceramic-on-ceramic hip joints: A spectroscopic investigation into the role of the polyethylene shell component
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DOI：
10.1016/j.jmbbm.2013.01.022
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发表时间：
2014-03-01
影响因子：
3.9
通讯作者：
Pezzotti, Giuseppe
中科院分区：
文献类型：
--
作者：
Okita, Shinya;Hasegawa, Masahiro;Pezzotti, Giuseppe
根据新收集的拉曼光谱结果，重新考虑了导致夹层插入（氧化铝/聚乙烯/钛）的模块化髋臼组件系统性故障的机制。对聚乙烯外壳进行了拉曼评估，该外壳属于一系列六个失败的夹层植入物，其体内寿命在 2 至 9 年之间。除一处例外外，所有植入物在修复手术前的射线照相分析中通常都显示出聚乙烯外壳的移位。聚乙烯壳从钛背衬壳中滑出，同时始终与陶瓷衬里保持完整。四个种植体在陶瓷内衬处断裂，但它们的断裂发生方式明显不同，可以合理化和分类。聚乙烯层的插入最初是为了降低陶瓷陶瓷轴承的刚性并防止陶瓷衬里边缘和股骨颈之间的碰撞，但由于蠕变变形（最终导致杯旋转和背面磨损）导致其初始（不对称）厚度减少，因此在植入物失效中发挥了作用。目前的光谱研究结果表明，将夹层型植入物简单化的故障分类为“陶瓷断裂故障”可能会产生误导，并且可能成为判断现代陶瓷植入物可靠性的混杂因素。 (C) 2013 Elsevier Ltd. 保留所有权利。
The mechanisms leading to systematic failure in modular acetabular components with a sandwich insertion (alumina/polyethylene/titanium) have been reconsidered in light of the newly collected Raman spectroscopic results. Raman assessments were conducted on the polyethylene shells, which belonged to a series of six failed sandwich implants with in vivo lifetimes ranging between 2 and 9 yr. With only one exception, all implants commonly showed dislodgment of the polyethylene shell during radiographic analyses prior to revision surgery. The polyethylene shell slipped out of the backing titanium shell, while always remaining integer to the ceramic liner. Four implants fractured at the ceramic liners, but their fractures occurred according to distinctly different patterns, which could be rationalized and classified. The insertion of the polyethylene layer, originally conceived to reduce the rigidity of the ceramic-on-ceramic bearing and to prevent impingement between the ceramic liner rim and the femoral neck, played a role in implant failure with its initial (asymmetric) thickness reduction due to creep deformation (eventually followed by cup rotation and backside wear). The results of the present spectroscopic investigation suggest that a simplistic failure classification of the sandwich-type implant as a "ceramic fracture failure" could be misleading and might represent a confounding factor in judging about the reliability of modern ceramic implants. (C) 2013 Elsevier Ltd. All rights reserved.