title: What's next? Alternative materials for articulation in total joint replacement.
abstract: The use of an artificial joint is always related to a certain amount of wear. Its biological effects, e.g., the osteolysis potential, are a function of the bulk material as well as its debris. Following comprehensive experiences with polyethylene (PE) wear, material science is tracking two ways to minimize the risk of a particle-induced aseptic implant loosening: (i) reduction of the PE debris by a low-wearing articulation partner; and (ii) replacement of the PE by other materials. Therefore, new ceramics (e.g., ZTA, Si(3)N(4)), as well as coatings (e.g., TiN, "diamond-like" carbon) and modifications of a bulk metal (e.g., oxidizes zirconium) or cushion bearings (polyurethane, hydrogels), are currently available for total joint replacements or have been used for pre-clinical testing. This review gives a brief overview and evaluates the potential of those that have recently been published in literature.
authors.affiliation: Laboratory of Biomechanics and Implant Research, Department of Orthopedics, Trauma surgery and Paraplegiology, Heidelberg University Hospital, Germany. robert.sonntag@med.uni-heidelberg.de
authors.forename: R
authors.initials: R
authors.lastname: Sonntag
authors.forename: J
authors.initials: J
authors.lastname: Reinders
authors.forename: J P
authors.initials: JP
authors.lastname: Kretzer
mesh_terms: D000818:Animals; D019643:Arthroplasty, Replacement / Q000379:methods*; D001672:Biocompatible Materials / Q000494:pharmacology*; D020099:Coated Materials, Biocompatible / Q000494:pharmacology; D006801:Humans; D007595:Joint Prosthesis; D016059:Range of Motion, Articular / Q000187:drug effects*; D013499:Surface Properties / Q000187:drug effects
chemical_list: D001672:Biocompatible Materials; D020099:Coated Materials, Biocompatible