Wear of HIPed and non-HIPed alumina-alumina hip joints under standard and severe simulator testing conditions
Wear of HIPed and non-HIPed alumina-alumina hip joints under standard and severe simulator testing conditions
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DOI：
10.1016/s0142-9612(00)00361-6
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发表时间：
2001-08-01
期刊：
影响因子：
14
通讯作者：
Fisher, J
中科院分区：
文献类型：
--
作者：
Nevelos, JE;Ingham, E;Fisher, J
人工关节的磨损和对磨损碎片的生物反应仍然是全髋关节置换术（THA）中的主要问题。 UHMWPE 磨损碎片的长期影响已有详细记录，这引起了人们对 THA 替代轴承材料的兴趣。氧化铝陶瓷-陶瓷髋关节已成功使用30多年，磨损小，骨质溶解发生率低。在回收的部件上观察到的最常见磨损模式是头部上的椭圆形磨损“条纹”以及杯上相应的磨损区域，磨损率约为 1-5 mm(3) pa。偶尔也会发生更严重的磨损，通常与异常的临床病史有关。现代氧化铝-氧化铝 THA 使用改进的 HIPed（热等静压）氧化铝陶瓷轴承材料，该材料可能更能抵抗严重磨损。先前的体外模拟器研究尚未复制体内磨损率或机制。本研究的目的是在“正常”和“严酷”测试条件下的髋关节模拟器中比较上一代非 HIP 氧化铝和现代 HIP 氧化铝。研究发现，经 HIP 处理的氧化铝的磨损率低于未经 HIP 处理的氧化铝，但在 95% 置信水平下差异并不具有统计显着性。在 Gelofusine(R) 和水润滑剂中进行的测试并未提高这两种材料的磨损率。高摆动阶段负载测试对两种材料的磨损率也没有显着影响。在没有任何润滑剂的情况下进行的测试仅在一个样本中对非 HIP 材料产生了非常严重的磨损。 (C) 2001 Elsevier Science Ltd. 保留所有权利。
Wear and the biological response to wear debris of artificial joints remain major concerns in total hip arthroplasty (THA). The long-term effects of UHMWPE wear debris are well documented and these have led to interest in alternate bearing materials for THA. Alumina ceramic-ceramic hip joints have been successfully used for more than 30 years with low wear and little incidence of osteolysis. The most common wear pattern observed on retrieved components is an elliptical wear 'stripe' on the heads and a corresponding worn area on the cup with an approximated wear rate of 1-5 mm(3) pa. More severe wear has also occasionally occurred, usually in association with an abnormal clinical history. Modern alumina-alumina THAs use an improved HIPed (hot isostatically pressed) alumina ceramic-bearing material which may be more resistant to severe wear. Previous in vitro simulator studies have not replicated in vivo wear rates or mechanisms. The aim of this study was to compare previous generation non-HIPed alumina and modern HIPed alumina in a hip joint simulator under 'normal' and 'harsh' testing conditions. HIPed alumina was found to have a lower wear rate than non-HIPed alumina, although the difference was not statistically significant at the 95% confidence level. Testing in Gelofusine(R) and water lubricants did not elevate the wear rates of either material. Elevated swing phase load testing also had no significant effect on the wear rates of either material. Testing in the absence of any lubricant produced very severe wear of the non-HIPed material in one specimen only. (C) 2001 Elsevier Science Ltd. All rights reserved.