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

Open Journal of Orthopedics 2020年第12期10卷 321-358页

作者： Ian C. Clarke Jean Yves Lazennec Evert Johannes Smith Thomas K. Donaldson Department of Orthopaedics Loma Linda University Medical Center Loma Linda CA USA Department of Orthopaedics La Pitié-Salpêtrière University Hospital Paris France Spire Bristol Hospital Bristol UK

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 data indicated THA risks included, 1) cup edge-loading (E/L) on heads producing “stripe wear”, 2) component impingement releasing metal particles resulting in 3) 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 found in all MOM retrievals. Basal-polar stripe combinations followed cup-rim profiles in our LLUMC simulations of prosthetic impingement. LPUH videos demonstrat

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 3rd-Body Wear

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