Ultra-high-molecular weight polyethylene wear: an in vitro comparison of acetabular metal types and polished surfaces.
The generation of debris from the wear of ultra-high-molecular weight polyethylene (UHMWPE) is a well-recognized factor in the development of osteolysis and the long-term failure of total joint arthroplasties. Wear between the articulation of the femoral head and the polyethylene has been recognized for many years, but more recently, both retrieval and in vitro studies have demonstrated that convex surface wear or backside wear also occurs and may be of significance. Currently, modular acetabular components are being designed with polished surfaces, fewer screw holes, various polyethylene locking mechanisms, and stiffer metal alloys in an attempt to reduce backside wear. The purpose of this study was to determine if differences existed in UHMWPE wear based on the metal alloy used and the surface finish in modular acetabular components. Sixteen components in 4 groups were subjected to 10 million gait cycles using an in vitro joint simulator. All components used 28-mm cobalt chrome femoral heads on cobalt chrome tapered stems. The 4 groups differed only in the type of metal backing and type of interior finished surface: polished cobalt chrome, unpolished cobalt chrome, polished titanium, and unpolished titanium. UHMWPE changes were examined in terms of articular (concave) surface wear, backside (convex) surface wear, and frictional torque. The overall linear and volumetric wear rates were 1.05 mm/10 million cycles and 325 mm3/10 million cycles. No significant differences in linear and volumetric wear rates were detected between the cobalt chrome and titanium acetabular components. Surface finish did not influence wear rates. In terms of backside wear, all specimens in the 4 groups demonstrated total loss of all sputtered gold with the exception of those areas extruded through the screw holes. Extrusion through the screw holes was on the order of 0.0004 inch for all groups, and no significant difference was seen among the groups for this parameter. The measurements of articular frictional torque demonstrated a significant difference among the polished and unpolished cobalt chrome components (17.3 N x m vs 11.5 N x m; P = .0039, 2-way analysis of variance, Student's Newman Keuls method). Some designs in modular acetabular components have favored stiffer alloys, such as cobalt chrome, with polished concave surfaces to decrease wear on both the concave and the convex surfaces. In this study, there was no significant difference in wear rates noted between cobalt chrome and titanium acetabular components, and polishing of the components had no appreciable affect in reducing backside wear.
Shepard
M F
MF
Department of Orthopaedic Surgery, UCLA School of Medicine, Los Angeles, California, USA.
Lieberman
J R
JR
Kabo
J M
JM
D000077:Acetabulum; D002858:Chromium Alloys; D006622:Hip Prosthesis; D006801:Humans; D008422:Materials Testing; D008970:Molecular Weight; D014025:Titanium; D019415:Torque
D002858:Chromium Alloys; D014025:Titanium