Simulator Wear Testing Protocols to Avoid Clinical Disaster

由DePuy Orthopaedics制造的ASR（关节面置换）系统是金属对金属（MM）髋关节植入物，由薄壁杯和多孔涂层后表面组成，用于骨向内生长。杯与一个大直径的头相连，直接连接在股骨（大腿骨）上，作为一个表面修复部件或锥形锁定在附着在股骨上的茎上。ASR植入系统在全球范围内用于93,000名患者，5年的失败率超过10%，并且随着越来越多的早期失败报告，失败率正在攀升。其他类似MM髋关节植入物在5年内的失败率约为1%，因此DePuy召回了ASR。这可能是历史上最广泛的骨科种植灾难，似乎是种植体接触金属表面过度磨损的结果。

| The ASR (articular surface replacement) systems made by DePuy Orthopaedics are metal-on-metal (MM) hip implants that consist of a thin-walled cup with a porous coated back surface for bone ingrowth. The cup articulates with a large diameter head that is directly attached to the femur (thigh bone) as a resurfacing component or taper locked to a stem that is attached to the femur. The ASR implant systems were used on 93,000 patients worldwide and the failure level at 5 years has exceeded 10% and is climbing higher as more early failures are being reported. The failure level for other similar MM hip implants at 5 years is about 1% and thus DePuy has recalled the ASR. This is perhaps the most extensive orthopaedic implant disaster in history and seems to be a consequence of excessive wear at the contacting metal surfaces of the implant.