Ceramic-on-metal for total hip replacement: Mixing and matching can lead to high wear

Saverio Affatato, Michele Spinelli, Mara Zavalloni, Francesco Traina, Simone Carmignato, Aldo Toni

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Ceramic-on-ceramic and metal-on-metal bearing surfaces are often employed for total hip replacement because of their resistance to wear. However, they have some limits: brittleness is a major concern for ceramic, and ion release is a drawback for metal. To reduce the effect of these limitations, a hybrid coupling of ceramic-on-metal has been proposed. The theoretical advantage of this new coupling might lead orthopedic surgeons to use it indiscriminately. We asked whether the wear rate of this innovative solution was comparable with that of ceramic-on-ceramic, which is considered to be the gold standard for wear resistance. In a hip simulator study, we tested the wear pattern of a hybrid ceramic-on-metal coupling supplied by the same distributor; in particular, three different configurations were tested for 5 million cycles: 36-mm ceramic-on-ceramic, 32-mm and 36-mm ceramic-on-metal. These combinations were gravimetrically and geometrically evaluated. After 5 million cycles, the volumetric loss for the metal acetabular cups (φ 36-mm) was 20-fold greater than that of the ceramic cups of the same size (φ 36-mm); a volumetric loss of 4.35 mm3 and 0.26 mm3 was observed, respectively, for ceramic-on-metal and ceramic-on-ceramic combinations. Significant statistical differences were observed between all 36-mm different combinations (P <0.0001). The increased diameter of the 36-mm ceramic-on-metal configuration resulted in a lower volumetric loss compared with that of the 32-mm ceramic-on-metal configuration. Our findings showed an increase in wear for the proposed hybrid specimens with respect to that of the ceramic-on-ceramic ones. This confirms that even in the case of ceramic-on-metal bearings, mixing and matching could not prove effective wear behavior, not even comparable with that of the ceramic-on-ceramic gold standard.

Original languageEnglish
Pages (from-to)319-323
Number of pages5
JournalArtificial Organs
Volume34
Issue number4
DOIs
Publication statusPublished - Apr 2010

Fingerprint

Hip Replacement Arthroplasties
Ceramics
Metals
Wear of materials
Bearings (structural)
Orthopedics
Brittleness
Wear resistance
Simulators
Ions

Keywords

  • Ceramic-on-ceramic
  • Ceramic-on-metal
  • Head-cup mismatch
  • Roundness
  • Wear rate

ASJC Scopus subject areas

  • Biomaterials
  • Biomedical Engineering
  • Bioengineering
  • Medicine (miscellaneous)

Cite this

Ceramic-on-metal for total hip replacement : Mixing and matching can lead to high wear. / Affatato, Saverio; Spinelli, Michele; Zavalloni, Mara; Traina, Francesco; Carmignato, Simone; Toni, Aldo.

In: Artificial Organs, Vol. 34, No. 4, 04.2010, p. 319-323.

Research output: Contribution to journalArticle

Affatato, Saverio ; Spinelli, Michele ; Zavalloni, Mara ; Traina, Francesco ; Carmignato, Simone ; Toni, Aldo. / Ceramic-on-metal for total hip replacement : Mixing and matching can lead to high wear. In: Artificial Organs. 2010 ; Vol. 34, No. 4. pp. 319-323.
@article{05b86b15f4a049d88519b519cb2241da,
title = "Ceramic-on-metal for total hip replacement: Mixing and matching can lead to high wear",
abstract = "Ceramic-on-ceramic and metal-on-metal bearing surfaces are often employed for total hip replacement because of their resistance to wear. However, they have some limits: brittleness is a major concern for ceramic, and ion release is a drawback for metal. To reduce the effect of these limitations, a hybrid coupling of ceramic-on-metal has been proposed. The theoretical advantage of this new coupling might lead orthopedic surgeons to use it indiscriminately. We asked whether the wear rate of this innovative solution was comparable with that of ceramic-on-ceramic, which is considered to be the gold standard for wear resistance. In a hip simulator study, we tested the wear pattern of a hybrid ceramic-on-metal coupling supplied by the same distributor; in particular, three different configurations were tested for 5 million cycles: 36-mm ceramic-on-ceramic, 32-mm and 36-mm ceramic-on-metal. These combinations were gravimetrically and geometrically evaluated. After 5 million cycles, the volumetric loss for the metal acetabular cups (φ 36-mm) was 20-fold greater than that of the ceramic cups of the same size (φ 36-mm); a volumetric loss of 4.35 mm3 and 0.26 mm3 was observed, respectively, for ceramic-on-metal and ceramic-on-ceramic combinations. Significant statistical differences were observed between all 36-mm different combinations (P <0.0001). The increased diameter of the 36-mm ceramic-on-metal configuration resulted in a lower volumetric loss compared with that of the 32-mm ceramic-on-metal configuration. Our findings showed an increase in wear for the proposed hybrid specimens with respect to that of the ceramic-on-ceramic ones. This confirms that even in the case of ceramic-on-metal bearings, mixing and matching could not prove effective wear behavior, not even comparable with that of the ceramic-on-ceramic gold standard.",
keywords = "Ceramic-on-ceramic, Ceramic-on-metal, Head-cup mismatch, Roundness, Wear rate",
author = "Saverio Affatato and Michele Spinelli and Mara Zavalloni and Francesco Traina and Simone Carmignato and Aldo Toni",
year = "2010",
month = "4",
doi = "10.1111/j.1525-1594.2009.00854.x",
language = "English",
volume = "34",
pages = "319--323",
journal = "Artificial Organs",
issn = "0160-564X",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Ceramic-on-metal for total hip replacement

T2 - Mixing and matching can lead to high wear

AU - Affatato, Saverio

AU - Spinelli, Michele

AU - Zavalloni, Mara

AU - Traina, Francesco

AU - Carmignato, Simone

AU - Toni, Aldo

PY - 2010/4

Y1 - 2010/4

N2 - Ceramic-on-ceramic and metal-on-metal bearing surfaces are often employed for total hip replacement because of their resistance to wear. However, they have some limits: brittleness is a major concern for ceramic, and ion release is a drawback for metal. To reduce the effect of these limitations, a hybrid coupling of ceramic-on-metal has been proposed. The theoretical advantage of this new coupling might lead orthopedic surgeons to use it indiscriminately. We asked whether the wear rate of this innovative solution was comparable with that of ceramic-on-ceramic, which is considered to be the gold standard for wear resistance. In a hip simulator study, we tested the wear pattern of a hybrid ceramic-on-metal coupling supplied by the same distributor; in particular, three different configurations were tested for 5 million cycles: 36-mm ceramic-on-ceramic, 32-mm and 36-mm ceramic-on-metal. These combinations were gravimetrically and geometrically evaluated. After 5 million cycles, the volumetric loss for the metal acetabular cups (φ 36-mm) was 20-fold greater than that of the ceramic cups of the same size (φ 36-mm); a volumetric loss of 4.35 mm3 and 0.26 mm3 was observed, respectively, for ceramic-on-metal and ceramic-on-ceramic combinations. Significant statistical differences were observed between all 36-mm different combinations (P <0.0001). The increased diameter of the 36-mm ceramic-on-metal configuration resulted in a lower volumetric loss compared with that of the 32-mm ceramic-on-metal configuration. Our findings showed an increase in wear for the proposed hybrid specimens with respect to that of the ceramic-on-ceramic ones. This confirms that even in the case of ceramic-on-metal bearings, mixing and matching could not prove effective wear behavior, not even comparable with that of the ceramic-on-ceramic gold standard.

AB - Ceramic-on-ceramic and metal-on-metal bearing surfaces are often employed for total hip replacement because of their resistance to wear. However, they have some limits: brittleness is a major concern for ceramic, and ion release is a drawback for metal. To reduce the effect of these limitations, a hybrid coupling of ceramic-on-metal has been proposed. The theoretical advantage of this new coupling might lead orthopedic surgeons to use it indiscriminately. We asked whether the wear rate of this innovative solution was comparable with that of ceramic-on-ceramic, which is considered to be the gold standard for wear resistance. In a hip simulator study, we tested the wear pattern of a hybrid ceramic-on-metal coupling supplied by the same distributor; in particular, three different configurations were tested for 5 million cycles: 36-mm ceramic-on-ceramic, 32-mm and 36-mm ceramic-on-metal. These combinations were gravimetrically and geometrically evaluated. After 5 million cycles, the volumetric loss for the metal acetabular cups (φ 36-mm) was 20-fold greater than that of the ceramic cups of the same size (φ 36-mm); a volumetric loss of 4.35 mm3 and 0.26 mm3 was observed, respectively, for ceramic-on-metal and ceramic-on-ceramic combinations. Significant statistical differences were observed between all 36-mm different combinations (P <0.0001). The increased diameter of the 36-mm ceramic-on-metal configuration resulted in a lower volumetric loss compared with that of the 32-mm ceramic-on-metal configuration. Our findings showed an increase in wear for the proposed hybrid specimens with respect to that of the ceramic-on-ceramic ones. This confirms that even in the case of ceramic-on-metal bearings, mixing and matching could not prove effective wear behavior, not even comparable with that of the ceramic-on-ceramic gold standard.

KW - Ceramic-on-ceramic

KW - Ceramic-on-metal

KW - Head-cup mismatch

KW - Roundness

KW - Wear rate

UR - http://www.scopus.com/inward/record.url?scp=77950876981&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77950876981&partnerID=8YFLogxK

U2 - 10.1111/j.1525-1594.2009.00854.x

DO - 10.1111/j.1525-1594.2009.00854.x

M3 - Article

C2 - 20420614

AN - SCOPUS:77950876981

VL - 34

SP - 319

EP - 323

JO - Artificial Organs

JF - Artificial Organs

SN - 0160-564X

IS - 4

ER -