title: Retrieval analysis of ceramic-coated metal-on-polyethylene total hip replacements.
abstract: Ceramic coatings have been used in metal-on-polyethylene (MOP) hips to reduce the risk of wear and also infection; the clinical efficacy of this remains unclear. This retrieval study sought to better understand the performance of coated bearing surfaces.
  
  
  
  Forty-three coated MOP components were analysed post-retrieval for evidence of coating loss and gross polyethylene wear. Coating loss was graded using a visual semi-quantitative protocol. Evidence of gross polyethylene wear was determined by radiographic analysis and visual inspection of the retrieved implants.
  
  
  
  All components with gross polyethylene wear (n = 10) were revised due to a malfunctioning acetabular component; 35 % (n = 15) of implants exhibited visible coating loss and the incidence of polyethylene wear in samples with coating loss was 54 %, significantly (p = 0.02) elevated compared to samples with intact coatings (14 %).
  
  
  
  In this study we found evidence of coating loss on metal femoral heads which was associated with increased wear of the corresponding polyethylene acetabular cups.
authors: Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
authors: Harman
authors: H
authors: Khatkar
authors: Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK. h.hothi@ucl.ac.uk.
authors: Harry
authors: H
authors: Hothi
authors: Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
authors: Danielle
authors: D
authors: de Villiers
authors: Orthopaedic Department, HELIOS Endo-Klinik, Hamburg, Germany.
authors: Christian
authors: C
authors: Lausmann
authors: Orthopaedic Department, HELIOS Endo-Klinik, Hamburg, Germany.
authors: Daniel
authors: D
authors: Kendoff
authors: Orthopaedic Department, HELIOS Endo-Klinik, Hamburg, Germany.
authors: Thorsten
authors: T
authors: Gehrke
authors: Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
authors: John
authors: J
authors: Skinner
authors: Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
authors: Alister
authors: A
authors: Hart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D002516:Ceramics / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005270:Femur Head; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D020959:Polyethylene / Q000009:adverse effects* / Q000627:therapeutic use; D011474:Prosthesis Design / Q000009:adverse effects*; D011475:Prosthesis Failure / Q000009:adverse effects / Q000209:etiology
chemical_list: D020959:Polyethylene
keywords: Coating; Hip; Metal-on-polyethylene; Retrieval; Wear