Prosthetic Impingement in Total Hip Arthroplasty—The Trigger for Adverse Wear

• 作者: Evert Johannes Smith Ian C. Clarke Jean Yves Lazennec Thomas K. Donaldson
• 来源期刊: 矫形学期刊(英文)
• 学科: 数学
• 关键词: Ceramic on Ceramic Edge-Loading IMPINGEMENT Metal Debris Metal on Metal Metal on Polyethylene Resurfacing Arthroplasty Retrieval Stripe Wear SUBLUXATION Total Hip Arthroplasty 3^rd-Body Wear
• 年，卷（期）: 2020,（12）
• 页码范围: 321-358
• 页数: 38页
• 分类号: O17

摘要

Development of total hip arthroplasty (THA) now spans more than 5 decades encompassing combinations of metal-on-metal (MOM), ceramic-on-metal (COM), metal-on-plastic (MOP), ceramic-on-plastic (COM), and ceramic-on-ceramic (COC). In every arena of extensive technical development, there exists a data set that when viewed in isolation seemed of little import, but when assembled in-toto may produce a generational shift in perception. Our review focused on two such THA events. Firstly, COC retrieval studies (1999-2001) noted habitual wear patterns on heads and peripheral wear stripes, along with femoral-neck impingement, and ceramic surfaces stained gray by metal debris. These COC<span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">data indicated THA risks included, </span><span style="font-family:Verdana;">1</span><span style="font-family:Verdana;">) cup edge-loading (E/L) on heads producing </span><span style="font-family:Verdana;">“</span><span style="font-family:Verdana;">stripe wear</span><span style="font-family:Verdana;">”</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> 2</span><span style="font-family:Verdana;">) component impingement releasing metal particles resulting in </span><span style="font-family:Verdana;">3</span><span style="font-family:Verdana;">) tissues contaminated by metal debris. A corresponding MOM impingement-debris mechanism was only perceived by Howie (2005) in a McKee-Farrar retrieval study. Our anticipation at LLUMC was that MOM retrievals would provide superior wear details to those seen on COC retrievals. We noted stripe wear in the polar zone of CoCr heads and basal stripes in the non-wear areas. The basal-polar stripe combinations were </span><span style="font-family:Verdana;">found in all MOM retrievals. Basal-polar stripe combinations followed cup-rim</span><span style="font-family:Verdana;"> profiles in our LLUMC simulations of prosthetic impingement. LPUH videos demonstrated the formation of stripe wear in functiona