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Volumetric wear assessment of failed metal-on-metal hip resurfacing prostheses

Lookup NU author(s): James Lord, David Langton, Professor Tom Joyce

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Abstract

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.


Publication metadata

Author(s): Lord JK, Langton DJ, Nargol AVF, Joyce TJ

Publication type: Article

Publication status: Published

Journal: Wear

Year: 2011

Volume: 272

Issue: 1

Pages: 79-87

Print publication date: 30/07/2011

ISSN (print): 0043-1648

ISSN (electronic): 1873-2577

Publisher: Elsevier BV

URL: http://dx.doi.org/10.1016/j.wear.2011.07.009

DOI: 10.1016/j.wear.2011.07.009


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