Common Features on Damage Mechanisms Identified on Various Metal and Ceramic on Polyethylene Articulating Surfaces of Total Hip Prostheses

Abstract

This paper presents a methodology for assessing the in-vivo degradation mechanisms of articular components of total hip replacement (THR) prostheses of Charnley type. The experimental procedure revealed that common features can be observed even if the clinical cases under investigation were quite different with regard to the demographic data. It particularly emphasises the detrimental effects of foreign bodies on the damage of the articulating surfaces. These foreign bodies can migrate into the joint space before embedding definitely into the Ultra High Molecular Weight Polyethylene (UHMWPE) acetabular cup surface where they further participate to a third body wear mechanism accelerated by a progressive increase of the femoral head roughness. Our experimental results underline, from a practical point of view, the need for careful manufacturing and clinical handling of porous surfaces, advocate for a systematic assessment of retrieved components, particularly when changed because of unexplained wear, and make questionable the clinical use of multifilament trochanteric cables.