1
|
Döring J, Buchholz A, Herbster M, Gehring J, Betke U, Chodór P, Zabrzyński J, Bertrand J, Lohmann CH, Łapaj Ł. Damage analysis of retrieved Biolox Ⓡdelta components used in hard and soft bearings. Acta Biomater 2023; 158:827-842. [PMID: 36599400 DOI: 10.1016/j.actbio.2022.12.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 01/02/2023]
Abstract
This retrieval study included 43 Biolox delta explants (18 CoC, 25 CoP). Implants were examined macroscopically, whereby damage was evaluated using a semi quantitative scoring system. Confocal microscopy was used to examine wear related damage patterns of the articulating surfaces. Scanning electron microscopy (SEM) with energy-dispersive X-ray spectroscopy (EDS) was used to analyze wear marks on the implant surface and wear debris in periprosthetic tissue samples. Raman spectroscopy and X-ray diffraction (XRD) were used to quantify monoclinic zirconia fractions. On all components, in vivo wear resulted predominantly in different damage patterns caused by metal transfer. In CoC bearings stripe wear was additionally detected, and some implants underwent severe damage due to component breakage. The wear scores were higher for CoC components, with no differences between the scores for CoC heads and liners. Wear features caused comparable roughening on implants from CoC and CoP bearings. SEM studies demonstrated that most wear marks were caused by metal debris released from implant components. Grain pull-out was observed in stripe wear regions. Monoclinic phase shift was observed in a similar quantity on components from CoP and CoC bearings. The increase of monoclinic zirconia content around metal deposits was minimal and was more pronounced in areas of stripe wear. The results of this study indicate, that ZTA components in general undergo minimal wear in both, CoC and CoP bearings, however, it is more pronounced in the former. Metal deposits, as the most common wear feature, have no significant effect on monoclinic phase transition. STATEMENT OF SIGNIFICANCE: In this paper, we classify all damage patterns macroscopically according to an established scoring system and assess them regarding surface roughness (confocal microscopy) and monoclinic phase content (Raman spectroscopy) in order to derive the severity for patients. We compare hard-hard and hard-soft bearings and relate damage patterns with metal transfer based on SEM/EDS examinations. Furthermore, we work out correlations between patient-specific data, cause of revision and the physical condition of each individual sample Our cohort consists of 43 Biolox delta retrievals, a comparatively large quantity. In addition, we address current topics such as metal transfer and, based on the classification of damage patterns, provide incentives and/or meaningful focal points for further research.
Collapse
Affiliation(s)
- Joachim Döring
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Magdeburg, Germany.
| | - Adrian Buchholz
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Maria Herbster
- Institute of Materials and Joining Technology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Jennifer Gehring
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Ulf Betke
- Institute of Materials and Joining Technology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Paweł Chodór
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznań, Poland
| | - Jan Zabrzyński
- Faculty of Medicine, Nicolas Copernicus University, Toruń, Collegium Medicum in Bydgoszcz, Poland
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Łukasz Łapaj
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznań, Poland
| |
Collapse
|
2
|
Is Surface Metastability of Today’s Ceramic Bearings a Clinical Issue? JOURNAL OF COMPOSITES SCIENCE 2021. [DOI: 10.3390/jcs5100273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Recent studies on zirconia-toughened alumina (ZTA) evidenced that in vivo aged implants display a much higher monoclinic zirconia content than expected from in vitro simulations by autoclaving. At the moment, there is no agreement on the source of this discrepancy: Some research groups ascribe it to the effect of mechanical impact shocks, which are generally not implemented in standard in vitro aging or hip walking simulators. Others invoke the effect of metal transfer, which should trigger an autocatalytic reaction in the body fluid environment, accelerating the kinetics of tetragonal-to-monoclinic transformation in vivo. Extrapolations of the aging kinetics from high (autoclave) to in vivo temperature are also often disputed. Last, Raman spectroscopy is by far the preferred method to quantify the amount of monoclinically transformed zirconia. There are, however, many sources of errors that may negatively affect Raman results, meaning that the final interpretation might be flawed. In this work, we applied Raman spectroscopy to determine the monoclinic content in as-received and in vitro aged ZTA hip joint implants, and in one long-term retrieval study. We calculated the monoclinic content with the most used equations in the literature and compared it with the results of X-ray diffraction obtained on a similar probe depth. Our results show, contrary to many previous studies, that the long-term surface stability of ZTA ceramics is preserved. This suggests that the Raman technique does not offer consistent and unique results for the analysis of surface degradation. Moreover, we discuss here that tetragonal-to-monoclinic transformation is also necessary to limit contact damage and wear stripe extension. Thus, the surface metastability of zirconia-containing ceramics may be a non-issue.
Collapse
|
3
|
Bistolfi A, Ferracini R, Aprato A, Massè A, Daghino W, Lea S, Artiaco S, Lee GC. Third generation delta ceramic-on-ceramic bearing for total hip arthroplasty at mid-term follow-up. J Orthop 2020; 22:397-401. [PMID: 32968340 DOI: 10.1016/j.jor.2020.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/23/2020] [Indexed: 02/08/2023] Open
Abstract
Purpose to evaluate the results of Delta ceramic-on-ceramic (CoC) for total-hip-arthroplasty (THA). Methods 261 THA using Delta-CoC, retrospectively analyzed. A 36 mm head was used in 189 cases and a 32/40 mm in the others. The series have been compared to a group of 89 THA with Forte-CoC. Results The Harris-Hip-Score improved from 49.1 ± 14.3 to 92.0 ± 8.9 (P < 0.001). In the Delta group there were one ceramic fracture and 2 dislocations. Two hips underwent revision. There were one revision in the Forte group for instability and one squeaking hip. Conclusions The new ceramic bearings provides a safe bearing for THA, with rare complications.
Collapse
Affiliation(s)
- Alessandro Bistolfi
- AO Città Della Salute e Della Scienza. Department of Orthopeadics, Traumatology and Rehabilitative Medicine, CTO Hospital, Turin, Italy
| | - Riccardo Ferracini
- Hoelloker Orthopaedics, Turin Italy. University of the Studies of Genova. Genova, Italy
| | - Alessandro Aprato
- AO Città Della Salute e Della Scienza. Department of Orthopeadics, Traumatology and Rehabilitative Medicine, CTO Hospital, Turin, Italy
| | - Alessandro Massè
- AO Città Della Salute e Della Scienza. Department of Orthopeadics, Traumatology and Rehabilitative Medicine, CTO Hospital, Turin, Italy.,Hoelloker Orthopaedics, Turin Italy. University of the Studies of Genova. Genova, Italy.,University of the Studies of Turin, Turin, Italy
| | - Walter Daghino
- AO Città Della Salute e Della Scienza. Department of Orthopeadics, Traumatology and Rehabilitative Medicine, CTO Hospital, Turin, Italy
| | - Sara Lea
- University of the Studies of Turin, Turin, Italy
| | - Stefano Artiaco
- AO Città Della Salute e Della Scienza. Department of Orthopeadics, Traumatology and Rehabilitative Medicine, CTO Hospital, Turin, Italy
| | - Gwo-Chin Lee
- Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Pennsylvania Hospital, USA
| |
Collapse
|
4
|
Cha MS, Huh YH, Cho LR, Park CJ. A comparative study of the wear of dental alloys against monolithic zirconia. J Prosthet Dent 2020; 123:866-873. [DOI: 10.1016/j.prosdent.2019.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/19/2019] [Accepted: 06/13/2019] [Indexed: 11/27/2022]
|
5
|
Zhao W, Li Y, Zhou A, Chen X, Li K, Chen S, Qiao B, Jiang D. Controlled release of basic fibroblast growth factor from a peptide biomaterial for bone regeneration. ROYAL SOCIETY OPEN SCIENCE 2020; 7:191830. [PMID: 32431879 PMCID: PMC7211882 DOI: 10.1098/rsos.191830] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/12/2020] [Indexed: 05/13/2023]
Abstract
Self-assembled peptide scaffolds based on D-RADA16 are an important matrix for controlled drug release and three-dimensional cell culture. In this work, D-RADA16 peptide hydrogels were coated on artificial bone composed of nano-hydroxyapatite/polyamide 66 (nHA/PA66) to obtain a porous drug-releasing structure for treating bone defects. The developed materials were characterized via transmission electron microscopy and scanning electron microscopy. The proliferation and adhesion of bone mesenchymal stem cells (BMSCs) were examined by confocal laser microscopy and CCK-8 experiments. The osteogenic ability of the porous materials towards bone BMSCs was examined in vitro by staining with Alizarin Red S and alkaline phosphatase, and bioactivity was evaluated in vivo. The results revealed that nHA/PA66/D-RADA16/bFGF reduces the degradation rate of D-RADA16 hydrogels and prolongs sustained release of bFGF, which would promote BMSCs proliferation, adhesion and osteogenesis in vitro and bone repair in vivo. Thus, it deserves more attention and is worthy of further research.
Collapse
Affiliation(s)
- WeiKang Zhao
- Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing, Yuzhong District 400016, People's Republic of China
- Department of Orthopaedics, Third Affiliated Hospital of Chongqing Medical University, No. 1 Shuanghu Road, Chongqing City, Yubei District 401120, People's Republic of China
| | - Yuling Li
- Department of Orthopaedics, Affiliated Hospital of North Sichuan Medical College, No. 63 Wenhua Road, Nanchong City, Sichuan Province 637000, People's Republic of China
| | - Ao Zhou
- Department of Orthopaedics, Third Affiliated Hospital of Chongqing Medical University, No. 1 Shuanghu Road, Chongqing City, Yubei District 401120, People's Republic of China
| | - Xiaojun Chen
- Department of Orthopaedics, Hospital (T.C.M) Affiliated to Southwest Medical University, No. 182 Chunhui Road, Luzhou City, Sichuan Province, 646000, People's Republic of China
| | - Kai Li
- Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing, Yuzhong District 400016, People's Republic of China
- Department of Orthopaedics, Third Affiliated Hospital of Chongqing Medical University, No. 1 Shuanghu Road, Chongqing City, Yubei District 401120, People's Republic of China
| | - Sinan Chen
- Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing, Yuzhong District 400016, People's Republic of China
- Department of Orthopaedics, Third Affiliated Hospital of Chongqing Medical University, No. 1 Shuanghu Road, Chongqing City, Yubei District 401120, People's Republic of China
| | - Bo Qiao
- Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing, Yuzhong District 400016, People's Republic of China
| | - Dianming Jiang
- Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing, Yuzhong District 400016, People's Republic of China
- Department of Orthopaedics, Third Affiliated Hospital of Chongqing Medical University, No. 1 Shuanghu Road, Chongqing City, Yubei District 401120, People's Republic of China
| |
Collapse
|
6
|
Wimmer MA, Pacione C, Yuh C, Chan YM, Kunze J, Laurent MP, Chubinskaya S. Articulation of an alumina-zirconia composite ceramic against living cartilage – An in vitro wear test. J Mech Behav Biomed Mater 2020; 103:103531. [DOI: 10.1016/j.jmbbm.2019.103531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 11/24/2022]
|
7
|
Nguyen TM, Weitzler L, Esposito CI, Porporati AA, Padgett DE, Wright TM. Zirconia Phase Transformation in Zirconia-Toughened Alumina Ceramic Femoral Heads: An Implant Retrieval Analysis. J Arthroplasty 2019; 34:3094-3098. [PMID: 31405633 DOI: 10.1016/j.arth.2019.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/27/2019] [Accepted: 07/10/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Zirconia-toughened alumina ceramic was introduced as a femoral head material for total hip arthroplasty. The material combines the stability of alumina with the toughness of zirconia. Despite inherent benefits for bearing surfaces, concern exists in the medical field that phase transformation of the zirconia grains could worsen wear resistance and lower the strength of the head. We examined these concerns in retrieved and artificially aged ceramic heads. METHODS Twenty-eight ceramic composite heads retrieved at revision surgery were combined with 5 pristine heads (as negative controls for phase transformation) and 5 artificially aged pristine heads (as positive controls). The extent of zirconia phase transformation at the bearing surfaces was examined through confocal Raman spectroscopy and X-ray diffraction. Burst testing was conducted on all pristine and aged heads and the 4 retrieved implants with the longest lengths of implantation. RESULTS Retrieved heads had higher maximum average volume fractions of the monoclinic phase compared to pristine or aged heads. Length of implantation was not correlated to the volume fraction of the monoclinic phase. All the heads achieved a burst load far above the 46 kN Food and Drug Administration acceptance criterion; 3 of the 4 retrieved heads had burst strengths exceeding 100kN. CONCLUSION Our results showed that phase transformation occurs in vivo in ceramic composite femoral heads, but the amount transformed did not increase with the length of time the head had been implanted. The negligible effect upon burst strength of the retrieved and artificially aged heads is reassuring. These results support continued clinical use of this alumina-zirconia composite material as a head material.
Collapse
Affiliation(s)
- Thu M Nguyen
- Department of Biomechanics, Hospital for Special Surgery, New York, NY
| | - Lydia Weitzler
- Department of Biomechanics, Hospital for Special Surgery, New York, NY
| | | | | | | | - Timothy M Wright
- Department of Biomechanics, Hospital for Special Surgery, New York, NY
| |
Collapse
|
8
|
Roy ME, Noel OF, Whiteside LA. Phase Transformation and Roughening in Artificially Aged and Retrieved Zirconia-Toughened Alumina Femoral Heads. J Arthroplasty 2019; 34:772-780. [PMID: 30642707 DOI: 10.1016/j.arth.2018.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/21/2018] [Accepted: 12/17/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Zirconia-toughened alumina (ZTA) used in hip arthroplasty contains yttria-stabilized zirconia (Y-TZP) as a toughening agent. However, Y-TZP is well known to degrade in vivo from tetragonal to monoclinic phase transformation. The stability of never-implanted ZTA femoral heads was evaluated in a severe artificial aging test, with retrieved ZTA heads also evaluated for clinical relevance. We hypothesized that ZTA would degrade due to tetragonal-to-monoclinic phase transformation, with changes in surface topography and progressive roughening. Y-TZP specimens served as a positive comparison group, while magnesia-stabilized zirconia (Mg-PSZ), which does not undergo phase transformation, served as a stable comparison group. METHODS Monoclinic phase concentration, surface topography, and roughness of never-implanted ZTA, Y-TZP, and Mg-PSZ heads were measured by X-ray diffraction and optical profilometry, before and after 2 rounds of 24 hours of hydrothermal aging. Explanted ZTA heads were characterized by the same methods. RESULTS After 48 hours in an autoclave, the surface of ZTA heads exhibited irregularly spaced protrusions about 20-30 nm high by 100-150 μm in diameter, with significant increases in monoclinic phase concentration (from 12.2% to 21.3%) and surface roughness. Similar features were observed on the surface of explanted ZTA heads, with 33% monoclinic phase after 2.7 years in vivo. CONCLUSION Based on data collected from ZTA retrievals, this artificial aging test underestimated the amount of phase transformation in vivo. Phase transformation and surface roughening of ZTA heads steadily increased without reaching a plateau, which may lead to stress concentrations and weakening of the ceramic material, and could result in late fracture and wear.
Collapse
Affiliation(s)
- Marie E Roy
- Missouri Bone & Joint Research Foundation, St. Louis, MO
| | - Oscar F Noel
- Missouri Bone & Joint Research Foundation, St. Louis, MO; Cincinnati SportsMedicine & Orthopaedic Center, Cincinnati, OH
| | - Leo A Whiteside
- Missouri Bone & Joint Research Foundation, St. Louis, MO; Signal Medical Corporation, Marysville, MI
| |
Collapse
|
9
|
Zhao W, He B, Zhou A, Li Y, Chen X, Yang Q, Chen B, Qiao B, Jiang D. D-RADA16-RGD-Reinforced Nano-Hydroxyapatite/Polyamide 66 Ternary Biomaterial for Bone Formation. Tissue Eng Regen Med 2019; 16:177-189. [PMID: 30989044 DOI: 10.1007/s13770-018-0171-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 11/11/2018] [Accepted: 11/23/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Nano-hydroxyapatite/polyamide 66 (nHA/PA66) is a composite used widely in the repair of bone defects. However, this material is insufficient bioactivity. In contrast, D-RADA16-RGD self-assembling peptide (D-RADA16-RGD sequence containing all D-amino acids is Ac-RADARADARADARADARGDS-CONH2) shows admirable bioactivity for both cell culture and bone regeneration. Here, we describe the fabrication of a favorable biomaterial material (nHA/PA66/D-RADA16-RGD). METHODS Proteinase K and circular dichroism spectroscopy were employed to test the stability and secondary structural properties of peptide D-RADA16-RGD respectively. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used to characterize the surface of these materials. Confocal laser scanning (CLS), cell counting kit-8 tests (CCK-8), alizarin red S staining, cell immunofluorescence analysis and Western blotting were involved in vitro. Also biosafety and bioactivity of them have been evaluated in vivo. RESULTS Proteinase K and circular dichroism spectroscopy demonstrated that D-RADA16-RGD in nHA/PA66 was able to form stable-sheet secondary structure. SEM and TEM showed that the D-RADA16-RGD material was 7-33 nm in width and 130-600 nm in length, and the interwoven pore size ranged from 40 to 200 nm. CLS suggests that cells in nHA/PA66/D-RADA16-RGD group were linked to adjacent cells with more actin filaments. CCK-8 analysis showed that nHA/PA66/D-RADA16-RGD revealed good biocompatibility. The results of Alizarin-red S staining and Western blotting as well as vivo osteogenesis suggest nHA/PA66/D-RADA16-RGD exhibits better bioactivity. CONCLUSION This study demonstrates that our nHA/PA66/D-RADA16-RGD composite exhibits reasonable mechanical properties, biocompatibility and bioactivity with promotion of bone formation.
Collapse
Affiliation(s)
- WeiKang Zhao
- 1The First Affiliated Hospital of Chongqing Medical University, No 1 Medicine Road, Yuzhong District, Chongqing, 400016 People's Republic of China.,2The Third Affiliated Hospital of Chongqing Medical University, No 1 Shuanghu Road, Yubei District, Chongqing, 401120 People's Republic of China
| | - Bin He
- 1The First Affiliated Hospital of Chongqing Medical University, No 1 Medicine Road, Yuzhong District, Chongqing, 400016 People's Republic of China
| | - Ao Zhou
- 2The Third Affiliated Hospital of Chongqing Medical University, No 1 Shuanghu Road, Yubei District, Chongqing, 401120 People's Republic of China
| | - Yuling Li
- Affiliated Hospital of Northern, Sichuan Medical University, Cultural Road 63, Nanchong City, 637000 Sichuan Province People's Republic of China
| | - Xiaojun Chen
- 2The Third Affiliated Hospital of Chongqing Medical University, No 1 Shuanghu Road, Yubei District, Chongqing, 401120 People's Republic of China
| | - Qiming Yang
- 2The Third Affiliated Hospital of Chongqing Medical University, No 1 Shuanghu Road, Yubei District, Chongqing, 401120 People's Republic of China
| | - Beike Chen
- 1The First Affiliated Hospital of Chongqing Medical University, No 1 Medicine Road, Yuzhong District, Chongqing, 400016 People's Republic of China.,2The Third Affiliated Hospital of Chongqing Medical University, No 1 Shuanghu Road, Yubei District, Chongqing, 401120 People's Republic of China
| | - Bo Qiao
- 1The First Affiliated Hospital of Chongqing Medical University, No 1 Medicine Road, Yuzhong District, Chongqing, 400016 People's Republic of China
| | - Dianming Jiang
- 1The First Affiliated Hospital of Chongqing Medical University, No 1 Medicine Road, Yuzhong District, Chongqing, 400016 People's Republic of China.,2The Third Affiliated Hospital of Chongqing Medical University, No 1 Shuanghu Road, Yubei District, Chongqing, 401120 People's Republic of China
| |
Collapse
|
10
|
Parkes M, Sayer K, Goldhofer M, Cann P, Walter WL, Jeffers J. Zirconia phase transformation in retrieved, wear simulated, and artificially aged ceramic femoral heads. J Orthop Res 2017; 35:2781-2789. [PMID: 28462520 PMCID: PMC5763359 DOI: 10.1002/jor.23589] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 03/28/2017] [Indexed: 02/04/2023]
Abstract
Zirconia in Zirconia toughened alumina ceramic hip replacements exists in an unstable state and can transform in response to stress giving the material improved fracture toughness. Phase transformation also occurs under hydrothermal conditions such as exist in vivo. To predict the hydrothermal aging that will occur in vivo accelerated aging procedures have been used, but validation of these models requires the study of retrieved hip joints. Here 26 retrievals are analysed to determine the degree of phase transformation in vivo. These were compared with virgin heads, heads that had undergone the accelerated aging process and heads wear tested to 5 million cycles in a hip simulator. Monoclinic content and surface roughness were measured using Raman spectroscopy and white light interferometry respectively. The monoclinic content for retrieved heads was 28.5% ± 7.8, greater than twice that in virgin, aged, or wear tested heads and did not have a significant correlation with time, contrary to the predictions of the hydrothermal aging model. The surface roughness for retrieved heads in the unworn area was not significantly different to that in virgin, aged, or unworn areas of wear tested heads. However in worn areas of the retrieved heads, the surface roughness was higher than observed in wear simulator testing. These results indicate that current testing methodologies do not fully capture the operational conditions of the material and the real performance of future new materials may not be adequately predicted by current pre-clinical testing methods. © 2017 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society 35:2781-2789, 2017.
Collapse
Affiliation(s)
- Maria Parkes
- Department of Mechanical EngineeringImperial College LondonLondonSW7 2AZUnited Kingdom
| | - Kathryn Sayer
- Department of Mechanical EngineeringImperial College LondonLondonSW7 2AZUnited Kingdom
| | | | - Philippa Cann
- Department of Mechanical EngineeringImperial College LondonLondonSW7 2AZUnited Kingdom
| | | | - Jonathan Jeffers
- Department of Mechanical EngineeringImperial College LondonLondonSW7 2AZUnited Kingdom
| |
Collapse
|
11
|
Raman and Photoemission Spectroscopic Analyses of Explanted Biolox ® Delta Femoral Heads Showing Metal Transfer. MATERIALS 2017; 10:ma10070744. [PMID: 28773102 PMCID: PMC5551787 DOI: 10.3390/ma10070744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/25/2017] [Accepted: 06/29/2017] [Indexed: 11/17/2022]
Abstract
Biolox® delta has been widely used in joint replacements thanks to its high strength and wear resistance. In this study, eleven Biolox® delta femoral head retrievals affected by metal transfer (MT) were analysed by Raman spectroscopy to estimate the tetragonal to monoclinic zirconia phase transformation, whose occurrence may compromise ceramic chemical stability and mechanical strength. The residual stress state was evaluated by both Raman and photoemission spectroscopy. Vm monoclinic zirconia contents were higher near the centre of the articulating surface and in the MT area than in the border control area of the retrievals. In only one retrieval, stress related to MT appeared a more severe condition, able to induce zirconia phase transformation; for all the others, stresses related to loading in the central region and related to MT, were conducive to a zirconia phase transformation of nearly the same extent. Vm depth profiling analyses showed that the transformation involved different thicknesses in different samples. Raman data allowed for the investigation of the mechanism of zirconia phase transformation and confirmed that the growth stage was absent and the nucleation stage was not occurring as freely as it would in unconstrained zirconia.
Collapse
|
12
|
Lee YK, Ha YC, Yoo JI, Jo WL, Kim KC, Koo KH. Mid-term results of the BIOLOX delta ceramic-on-ceramic total hip arthroplasty. Bone Joint J 2017; 99-B:741-748. [DOI: 10.1302/0301-620x.99b6.bjj-2016-0486.r3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 01/18/2017] [Indexed: 11/05/2022]
Abstract
Aims We conducted a prospective study of a delta ceramic total hip arthroplasty (THA) to determine the rate of ceramic fracture, to characterise post-operative noise, and to evaluate the mid-term results and survivorship. Patients and Methods Between March 2009 and March 2011, 274 patients (310 hips) underwent cementless THA using a delta ceramic femoral head and liner. At each follow-up, clinical and radiological outcomes were recorded. A Kaplan-Meier analysis was undertaken to estimate survival. Results Four patients (four hips) died and 18 patients (20 hips) were lost to follow-up within five years. The remaining 252 patients (286 hips) were followed for a mean of 66.5 months (60 to 84). There were 144 men (166 hips) and 108 women (120 hips) with a mean age of 49.7 years (16 to 83) at surgery. The mean pre-operative Harris Hip Score of 47.1 points improved to 93.8 points at final follow-up. Six patients reported squeaking in seven hips; however, none were audible. Radiolucent lines involving Gruen zones one and/or seven were seen in 52 hips (18.2%). No hip had detectable wear, focal osteolysis or signs of loosening. One hip was revised because of fracture of the ceramic liner, which occurred due to an undetected malseating of the ceramic liner at the time of surgery. One hip was revised for a periprosthetic fracture of the femur, and one hip was treated for periprosthetic joint infection. The six-year survivorship with re-operation for any reason as the endpoint was 99.0% (95% confidence interval 97.8% to 100%). Discussion The rate of delta ceramic fracture was 0.3% (one of 286). While ceramic head fracture was dominant in previous ceramic-on-ceramic THA, fracture of the delta ceramic liner due to malseating is a concern. Cite this article: Bone Joint J 2017;99-B:741–8.
Collapse
Affiliation(s)
- Y. K. Lee
- Seoul National University Bundang Hospital, 82
Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do
463-707, South Korea
| | - Y. C. Ha
- Chung-Ang University College of Medicine, 102
Heukseok-ro, Dongjak-ku, Seoul
156-755, South Korea
| | - J-I. Yoo
- Gyeongsang National University Hospital, 90
Chilamdong, Jinju, Gyeongnamdo
660-702, South Korea
| | - W. L. Jo
- St. Mary’s Hospital, 222, Banpo-daero, Seocho-gu, Seoul, 06591, South
Korea
| | - K-C. Kim
- Dankook University Hospital, 119
Dandae-ro, Dongnam-gu, Cheonan
si, Chungnam 31116, South
Korea
| | - K. H. Koo
- Seoul National University Bundang Hospital, 82
Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do
463-707, South Korea
| |
Collapse
|
13
|
Cartner J, Aldinger P, Li C, Collins D. Characterization of Femoral Head Taper Corrosion Features Using a 22-Year Retrieval Database. HSS J 2017; 13:35-41. [PMID: 28167872 PMCID: PMC5264572 DOI: 10.1007/s11420-016-9517-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 07/07/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Modularity in total hip arthroplasty has been used for decades with great success, but new findings regarding corrosion artifacts have caused a resurgence in tapered junction research. Mechanically assisted crevice corrosion (MACC) is thought to be the mechanism by which corrosive attack occurs. Myriad multi-factorial variables are known to influence the susceptibility of a modular taper junction to MACC. Some of these variables are design and manufacture related and others can be controlled by the surgeon. QUESTIONS/PURPOSES This study was performed to assess a 22-year retrieval database to determine if correlations exist between severity of corrosion artifacts and head size, time in vivo, head offset, or head material. Secondarily, the agreement of visual and semi-quantitative scoring methods was assessed using the retrieved components. METHODS A total of 210 femoral head tapers were scored and heads receiving high scores were measured to quantify material loss due to MACC. RESULTS Increased head size and increased time in vivo did not correlate to higher corrosion scores. Contrarily, there were differences in corrosion scores based on femoral head offset and material. Deviations away from a neutral offset (where neutral is defined as the alignment of femoral head center and stem taper gage point) resulted in higher scores. Cobalt-chromium-molybdenum heads were associated with higher corrosion scores and higher material loss as compared to oxidized zirconium heads. CONCLUSION Reducing the moment arm at the head-neck junction and choosing a more inert material appears to provide greater resistance to corrosion.
Collapse
Affiliation(s)
- Jacob Cartner
- Smith & Nephew, 1450 Brooks Road, Memphis, TN 38116 USA
| | | | - Chenxi Li
- Smith & Nephew Orthopaedic Ltd, Implant Development Centre, Leamington Spa, UK
| | - David Collins
- Smith & Nephew Orthopaedic Ltd, Implant Development Centre, Leamington Spa, UK
| |
Collapse
|
14
|
Affatato S, De Mattia JS, Bracco P, Pavoni E, Taddei P. Wear performance of neat and vitamin E blended highly cross-linked PE under severe conditions: The combined effect of accelerated ageing and third body particles during wear test. J Mech Behav Biomed Mater 2016; 64:240-52. [PMID: 27522313 DOI: 10.1016/j.jmbbm.2016.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/28/2016] [Accepted: 08/01/2016] [Indexed: 12/28/2022]
Abstract
The objective of this study is to evaluate the effects of third-body particles on the in vitro wear behaviour of three different sets of polyethylene acetabular cups after prolonged testing in a hip simulator and accelerated ageing. Vitamin E-blended, cross-linked polyethylene (XLPE_VE), cross-linked polyethylene (XLPE) and conventional polyethylene (STD_PE) acetabular cups were simulator tested for two million cycles under severe conditions (i.e. by adding third-body particles to the bovine calf serum lubricant). Micro-Fourier Transform Infrared and micro-Raman spectroscopic analyses, differential scanning calorimetry, and crosslink density measurements were used to characterize the samples at a molecular level. The STD_PE cups had twice mass loss than the XLPE_VE components and four times than the XLPE samples; statistically significant differences were found between the mass losses of the three sets of cups. The observed wear trend was justified on the basis of the differences in cross-link density among the samples (XLPE>XLPE_VE>STD_PE). FTIR crystallinity profiles, bulk DSC crystallinity and surface micro-Raman crystallinity seemed to have a similar behaviour upon testing: all of them (as well as the all-trans and ortho-trans contents) revealed the most significant changes in XLPE and XLPE_VE samples. The more severe third-body wear testing conditions determined more noticeable changes in all spectroscopic markers with respect to previous tests. Unexpectedly, traces of bulk oxidation were found in both STD_PE (unirradiated) and XLPE (remelting-stabilized), which were expected to be stable to oxidation; on the contrary, XLPE_VE demonstrated a high oxidative stability in the present, highly demanding conditions.
Collapse
Affiliation(s)
- Saverio Affatato
- Medical Technology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy.
| | | | - Pierangiola Bracco
- Chemistry Department and Nanostructured Interfaces and Surfaces (NIS) Centre, University of Turin, Via Giuria 7, 10125 Turin, Italy
| | - Eleonora Pavoni
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Via Belmeloro 8/2, 40126 Bologna, Italy
| | - Paola Taddei
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Via Belmeloro 8/2, 40126 Bologna, Italy
| |
Collapse
|
15
|
Li Y, Li H, Zhang J, Zhao W, Shen J, Jiang D. In vitro evaluation of an yttria-stabilized zirconia reinforced nano-hydroxyapatite/polyamide 66 ternary biomaterial: biomechanics, biocompatibility and bioactivity. RSC Adv 2016. [DOI: 10.1039/c6ra24509a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The characterization of a novel ternary biomaterial composed of nano-hydroxyapatite/polyamide 66/yttria-stabilized tetragonal zirconia.
Collapse
Affiliation(s)
- Yuling Li
- Department of Orthopedics
- The First Affiliated Hospital of Chongqing Medical University
- Chongqing
- People's Republic of China
| | - Hong Li
- Research Center for Nano-Biomaterials
- Analytical and Testing Center
- Sichuan University
- Chengdu
- People's Republic of China
| | - Jing Zhang
- Department of Gastroenterology
- The Affiliated Hospital of North Sichuan Medical College
- Nanchong
- People's Republic of China
| | - Weikang Zhao
- Department of Orthopedics
- The First Affiliated Hospital of Chongqing Medical University
- Chongqing
- People's Republic of China
| | - Jieliang Shen
- Department of Orthopedics
- The First Affiliated Hospital of Chongqing Medical University
- Chongqing
- People's Republic of China
| | - Dianming Jiang
- Department of Orthopedics
- The First Affiliated Hospital of Chongqing Medical University
- Chongqing
- People's Republic of China
| |
Collapse
|
16
|
Does Metal Transfer Differ on Retrieved Ceramic and CoCr Femoral Heads? BIOMED RESEARCH INTERNATIONAL 2015; 2015:283038. [PMID: 26583097 PMCID: PMC4637014 DOI: 10.1155/2015/283038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 07/13/2015] [Accepted: 07/28/2015] [Indexed: 11/17/2022]
Abstract
Metal transfer has been observed on retrieved THA femoral heads for both CoCr and ceramic bearing materials. In vitro wear testing has shown increased wear to polyethylene acetabular liners with the presence of metal transfer. This study sought to investigate the extent of metal transfer on the bearing surface of CoCr and ceramic femoral heads and identify prevalent morphologies. Three bearing couple cohorts: M-PE (n = 50), C-PE (n = 35), and C-C (n = 15), were derived from two previously matched collections (n = 50/group) of CoCr and ceramic femoral heads. From the three cohorts, 75% of the femoral heads showed visual evidence of metal transfer. These femoral heads were analyzed using direct measurement, digital photogrammetry, and white light interferometry. Surface area coverage and curved median surface area were similar among the three cohorts. The most prevalent metal transfer patterns observed were random stripes (n = 21/75), longitudinal stripes (n = 17/75), and random patches (n = 13/75). Metal transfer arc length was shorter in the M-PE cohort. Understanding the morphology of metal transfer may be useful for more realistic recreation of metal transfer in in vitro pin-on-disk and joint simulators studies.
Collapse
|