Osteolysis with Ceramic on Highly Cross-linked Polyethylene
A major reason for the longevity of native articular cartilage over that of materials used in arthroplasties is the former’s ability to self-lubricate. The self-lubricating property of hyaline cartilage produces an extraordinarily low coefficient of friction between the joint surfaces. So long as shear stresses remain low or the architecture of the joint unchanged by trauma, native articular cartilage can provide for a lifetime of joint function, i.e. the ankle. Therefore, wear and the particulate debris created by surface wear presents a significant challenge to the arthroplasty community. [1,2] Over the past 100 years, many materials have been introduced to address this issue: ivory, wood, gold, bioglass, stainless steel, cobalt/chrome alloys, Teflon, polyethylene, ceramics, diamond. To date, although there has been significant improvement in the wear properties of bearing surfaces, no perfect surrogate for native articular cartilage has been found. Presently, ceramic on highly cross-linked polyethylene (COP) appears to be the best available option. However, although it has been demonstrated to produce less particulate debris than metal on polyethylene (MOP) articulations in the hip, it is not immune to the same osteolytic complication seen in MOP bearings.
Keywords: osteolysis; ceramic on highly cross-linked polyethylene
Ohnsarge JA, Davis JD, et al. Early polyethylene wear and excessive acetabular granuloma in uncemented HA-coated THA – midterm results of a prospective study. Hosp for Spec. Surg. J. (2006) 2: 114-120.
Mueller ME. The benefits of metal-on-metal THR. Clin Ortho Rel Res (1995) #311: p. 54-59.
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