Wear properties of polyethylene-metal and polyethylene-ceramic bearings for hip joint replacements: The effect of temperature and protein precipitation in hip simulator tests.

摘要

Ultra-high-molecular weight polyethylene (PE) cups bearing against metal or ceramic balls are the most commonly used combinations of materials for human hip joint replacements. The wear properties of these materials are typically evaluated in the laboratory using hip joint wear simulators, while lubricated with bovine serum. A previous test evaluating the PE cups against cobalt-chrome (CoCr), zirconia (Zr) and alumina balls demonstrated the sensitivity of serum proteins to elevated temperature; especially for Zr/PE, which showed the highest protein precipitation and bulk lubricant temperature but the lowest cup wear. In the present investigation, a temperature control system was used on a hip simulator to systematically evaluate the relationship between temperature and denaturation of the serum proteins which, in turn, affects the friction and wear properties of the prosthetic materials being tested. In order to control protein precipitation, the interface was temperature reduced by circulating coolant at 4°C through the center of the CoCr or Zr balls during a wear test. With cooling, protein assay of the serum showed 66% and 50% reductions in protein precipitation with the CoCr and Zr balls, respectively. The wear rate of the PE cups against the CoCr balls decreased by an average of 44%, whereas two of the three PE cups running against Zr balls exhibited slight increases in their wear rates, and the third showed a two fold increase. Under scanning electron microscopy, there were marked differences in the worn surfaces of the cups for the various conditions, and differences in the morphology of the PE wear debris recovered from the serum. For example, granular particles predominated without cooling, whereas fibrous particles predominated with cooling. Since particles generated in vivo (i.e., retrieved from periprosthetic tissues) typically show approximately equal proportions of granules and fibrils, the use of an intermediate coolant temperature might provide wear in the simulator closer to that occurring with these materials in vivo. These results demonstrated the complex interaction of the variables affecting wear in the hip simulator system that should be taken into account, for example, in the development of international standard procedures.