In the last two decades the performance of total hip replacements (THR) has constantly improved, thanks largely to advances in the field of material science and technology. Although contemporary devices are clinically very reliable, some problems still need to be addressed: the wear of ultra high molecular weight polyethylene components, the release of metal ions from metal-on-metal joints, the toughness of the ceramic cups and the possibility of squeaking for ceramic-on-ceramic couplings. All these drawbacks become particularly relevant in case of THR for young and active patients, when the life expectancy of the orthopedic device is very high and the possibility of mechanical shocks is not negligible.
In the last few years an innovative ceramic-on-metal tribologic coupling has been introduced in clinical use. This novel con-figuration represents a very promising solution to all the aforementioned issues. Ceramic-on-metal offers both the strength points of ceramic and metal surfaces, and overcomes the limits of metal-on-metal and ceramic-on-ceramic bearings. For this reason, the ceramic-on-metal coupling has become the object of investigation for several laboratory studies and has been tested in clinical trials. This review study compares the scientific outcomes of the research on ceramic-on-metal bearings, confirming that this innovative articulation has the potential to be a suitable and attractive solution for young and active patients.
FisherJ, InghamE, StoneMH.Alternative bearing couples in total hip replacements: Solutions for young patients.HIP International2003; 13: S31–5.
2.
ChiesaR, TanziMC, AlfonsiS, ParacchiniL, MoscatelliM, CigadaA, Enhanced wear performance of highly crosslinked UHMWPE for artificial joints.J Biomed Mater Res2000; 50: 381–7.
3.
ChiesaR, MoscatelliM, GiordanoC, SiccardiF, CigadaA, Influence of heat treatment on structural, mechanical and wear properties of crosslinked UHMWPE.J Appl Biomater Biomech2004; 2: 20–8.
4.
FerroniD, QuagliniV, Thermal stabilization of highly crosslinked UHMWPE: A comparative study between annealed and remelted resins.J Appl Biomater Biomech2010; 8: 82–8.
5.
MoscatelliM, FarèS, DelvecchioE, Structural, mechanical and wear resistance assessment of UHMWPE orthopedic components.J Appl Biomater Biomech2006; 4: 165–71.
6.
McKellopHM, ParkSH, ChiesaR, Three types of metal-metal hip prostheses during two decades of use.Clin Orthop Relat Res1996; 329S.
7.
BilliF, CampbellP.Nanotoxicology of metal wear particles in total joint arthroplasty: a review of current concepts.J Appl Biomater Biomech2010; 8: 1–6.
8.
UrbanRM, JacobsJJ, TomlinsonMJ, GavrilovicJ, BlackJ, Peoc'hM.Dissemination of wear particles to the liver, spleen, and abdominal lymph nodes of patients with hip or knee replacement.J Bone Joint Surg - Series A2000; 82: 457–77.
9.
MahendraG, PanditH, KliskeyK, MurrayD, GillHS, AthanasouN.Necrotic and inflammatory changes in metal-on-metal resurfacing hip arthroplasties.Acta Orthop2009; 80: 653–9.
10.
HannoucheD, NichC, BizotP, MeunierA, NizardR, SedelL.Fractures of ceramic bearings: history and present status.Clin Orthop2003: 19–26.
11.
LeslieIJ, WilliamsS, IsaacG, InghamE, FisherJ.High cup angle and microseparation increase the wear of hip surface replacements.Clin Orthop2009; 467: 2259–65.
12.
WidmerK, ZurfluhB.Compliant positioning of total hip components for optimal range of motion.J Orthop Res2004; 22: 815–21.
FisherJ.Ceramic-on-metal hip implants to undergo trials.Advanced Materials and Processes2005; 163: 60–1.
15.
HsuS, GatesR.Boundary lubrication and boundary lubricating films.In: Barat Bushan ed. Modern tribology handbook, Two Volume Set. Boca Raton: CRC Press,2001; 455–86.
16.
WangFC, BrockettC, WilliamsS, UdofiaI, FisherJ, JinZM.Lubrication and friction prediction in metal-on-metal hip implants.Phys Med Biol2008; 53: 1277–93. Epub 2008 Feb 13.
17.
FirkinsPJ, TipperJL, SaadatzadehMR, InghamE, StoneMH, FarrarR, FisherJ.Quantitative analysis of wear and wear debris from metal-on-metal hip prostheses tested in a physiological hip joint simulator.Biomed Mater Eng2001; 11: 143–57.
18.
FisherJ, JinZ, TipperJ, StoneM, InghamE.Presidential guest lecture: Tribology of alternative bearings.Clin Orthop Relat Res2006; 453: 25–34.
19.
BrockettC, WilliamsS, JinZ, IsaacG, FisherJ.Friction of total hip replacements with different bearings and loading conditions.J Biomed Mater Res Part B Appl Biomater2007; 81: 508–15.
20.
WilliamsS, JinZM, StoneMH, InghamE, FisherJ.The effect of different lubrication regimes and lubricants on the friction hard-on-hard total hip replacements.Proc World Tribol Cong2005; 2: 625–6.
21.
WilliamsS, SchepersA, IsaacG, HardakerC, InghamE, JagtDVD, BreckonA, FisherJ.Ceramic-on-metal hip arthroplasties: A comparative in vitro and in vivo study.Clin Orthop Relat Res2007; 465: 23–32.
22.
WilliamsS, StewartTD, InghamE, StoneMH, FisherJ.Metal-on-metal bearing wear with different swing phase loads.J Biomed Mater Res B Appl Biomater2004; 70: 233–9.
23.
WilliamsS, BrockettCL, HardakerC, IsaacGH, FisherJ.Novel ceramic-on-metal hip replacements.J Bone Joint Surg Br2011; 93B: 35b.
24.
Al-HajjarM, LeslieIJ, TipperJ, WilliamsS, FisherJ, JenningsLM.Effect of cup inclination angle during microseparation and rim loading on the wear of BIOLOX® delta ceramic-on-ceramic total hip replacement.J Biomed Mater Res B Appl Biomater2010; 95: 263–8.
25.
IshidaT, ClarkeIC, DonaldsonTK, ShirasuH, ShishidoT, YamamotoK.Comparing ceramic-metal to metal-metal total hip replacements - A simulator study of metal wear and ion release in 32- and 38-mm bearings.J Biomed Mater Res B Appl Biomater2009; 91: 887–96.
26.
BarnesCL, DeBoerD, CorpeRS, NambuS, CarrollM, TimmermanI.Wear Performance of Large-Diameter Differential-Hardness Hip Bearings.J Arthroplasty2008; 23: 56–60.
27.
AffatatoS, SpinelliM, ZavalloniM, TrainaF, CarmignatoS, ToniA.Ceramic-on-metal for total hip replacement: Mixing and matching can lead to high wear.Artif Organs2010; 34: 319–23.
28.
BrownC, WilliamsS, TipperJL, FisherJ, InghamE.Characterisation of wear particles produced by metal on metal and ceramic on metal hip prostheses under standard and microseparation simulation.J Mater Sci Mater Med2007; 18: 819–27.
29.
PinaC, YanY, NevilleA; FisherJ.Analysis of corrosive wear in metal on metal and ceramic on metal bearings for hip prostheses.53th Orthopaedic Research Society Annual Meeting, San Diego2007, paper 1777.
30.
YanY, NevilleA, DowsonD, WilliamsS, FisherJ.Tribo-corrosion analysis of wear and metal ion release interactions from metal-on-metal and ceramic-on-metal contacts for the application in artificial hip prostheses.Proc Inst Mech Eng Part J2008; 222: 483–92.
31.
IsaacGH, BrockettC, BreckonA, Van Der JagtD, WilliamsS, HardakerC, FisherJ, SchepersA.Ceramic-on-metal bearings in total hip replacement: Whole blood metal ion levels and analysis of retrieved components.J Bone Joint Surg - Series B2009; 91: 1134–41.
