Harman Khatkar1, Harry Hothi2, Danielle de Villiers1, Christian Lausmann3, Daniel Kendoff3, Thorsten Gehrke3, John Skinner1, Alister Hart1. 1. Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK. 2. 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. 3. Orthopaedic Department, HELIOS Endo-Klinik, Hamburg, Germany.
Abstract
PURPOSE: 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. METHODS: 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. RESULTS: 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 %). CONCLUSIONS: 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.
PURPOSE: 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. METHODS: 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. RESULTS: 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 %). CONCLUSIONS: 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: Harry S Hothi; Reshid Berber; Robert K Whittaker; Paul J Bills; John A Skinner; Alister J Hart Journal: Hip Int Date: 2015-04-24 Impact factor: 2.135
Authors: Francesco Pisanu; Carlo Doria; Matteo Andreozzi; Marco Bartoli; Laura Saderi; Giovanni Sotgiu; Paolo Tranquilli Leali Journal: Int Orthop Date: 2018-09-29 Impact factor: 3.075