Skip to main content
SpringerLink
Log in

Implant materials for hip endoprostheses: old proofs and new trends

  • Original Article
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

To judge the significance of a hip joint replacement, the clinical results over 10–20 years must be evaluated. Today, still over half of all hip endoprostheses involves cement fixation. The rest is uncemented, in direct contact with bone. Total hip prostheses with polyethylene cups are equipped either with cobalt-, iron-, surface-hardened titanium-based metal or Al2O3 ceramic ball heads. The pairing Al2O3/Al2O3 and CoCrMoC metal/metal for cups and balls are extremely wear resistant. Most of the cementless cups have spherical or conical cobalt- or titanium-based metal shells with inserts made of polyethylene or CoCrMoC metal. For the fixation stems, high-strength iron-, cobalt- or titanium-based wrought metals are preferred. A taper spigot connection between metallic or ceramic ball heads and stems allows a modular design of hip joint replacements. We have learnt much from the mistakes of the last 40 years in hip endoprosthetics, and there is no excuse to repeat them again.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Charnley J (1979) Low friction arthroplasty of the hip. Springer, Berlin Heidelberg New York

    Google Scholar 

  2. Draenert K (1986) Beobachtungen zur Zementierung von Implantatkomponenten. Med Orthop Technol 6:200–205

    Google Scholar 

  3. Dujovne AR, Bobyn JD, Krygier JJ, Wilson DR, Brooks CE (1992) Fretting at the head/neck taper of modular hip prostheses. Transactions of 4th World Biomaterials Congress, Berlin, p 264

  4. Jantsch S, Schwägerl W (1990) Mittelfristige Verlaufskontrollen der zementfreien Schaftverankerung. In: Zweymüller K (ed) 10 Jahre Zweymüller-Hüftendoprothese. Verlag Hans Huber, Bern, pp 117–123

    Google Scholar 

  5. Kempf I, Semlitsch M (1990) Massive wear of a steel ball head by ceramic fragments in the polyethylene acetabular cup after revision of a total hip prosthesis with fractured ceramic ball. Orthop Trauma Surg 109:284–287

    Google Scholar 

  6. Ling RSM (1979) Cementing techniques. Revision Arthroplasty, Sheffield, pp 19–32

    Google Scholar 

  7. Lintner F, Böhm G, Bösch P, Endler M, Zweymüller K (1988) 1st hochdichtes Polyethylen als Implantatmaterial zur zementfreien Verankerung von Hüftendoprothesen geeignet? Z Orthop 126:688–692

    Google Scholar 

  8. Limner F, Böhm G, Zweymüller K, Endler M, Koitz S, Brand G (1988) Die Verträglichkeit von Polyethylen in der direkten Verankerung zum Knochen. Proc. 14. Jahrestagung der Österr. Ges. für Biomed. Technik, pp 76–79

  9. Limner F, Böhm G, Brand G (1990) Bone reactions to hip joint replacements made of titanium alloys. Titanium Int. Conf., pp 672–688

  10. Lintner F, Böhm G, Bösch P, Brand G, Endler M, Zweymüller K (1991) Results of histological and microradiographical examination of cementless implanted polyethylene threaded hip sockets. In: Willert HG, Eyerer P, Buchhorn GH (eds) UHMW Polyethylene as biomaterial in orthopedic surgery. Hogrefe & Huber, Toronto Lewiston NY Bern Göttingen Stuttgart, pp 173–180

    Google Scholar 

  11. Mittelmeier H, Heisel J (1986) 10 Jahre Erfahrungen mit Keramik-Hüftendoprothesen. Med. Lit. Verlagsges., Uelzen

    Google Scholar 

  12. Morscher E, Dick W, Kernen V (1982) Cementless fixation of polyethylene acetabular component in total hip arthroplasty. Arch Orthop Trauma Surg 99:223–230

    Google Scholar 

  13. Neugebauer H (1988) Was gibt es Neues in der Medizin? Peter Müller Verlag, Wien, p 17

    Google Scholar 

  14. Remagen W, Morscher E (1984) Histological results with cement-free implanted hip joint sockets of polyethylene. Arch Orthop Trauma Surg 103:145–151

    Google Scholar 

  15. Semlitsch M (1974) Technical progress in artificial hip joints. Eng Med I Mech E 3:10–19

    Google Scholar 

  16. Semlitsch M (1979) Eigenschaften der CoNiCrMo-Schmiedelegierung Protasul-10 für Gelenkendoprothesen mit klinischer Anwendung seit 1971. Swiss Med 1, 9:15–21

    Google Scholar 

  17. Semlitsch M (1992) 25 years Sulzer development of implant materials for total hip prostheses. Medicajournal 1:4–9

    Google Scholar 

  18. Semlitsch M (1993) CoCrMoC metal/metal articulation as a solution to the problem of wear of hip joint replacements. I Mech E Annual Expert Meeting Failure of Joint Prostheses, Bournemouth, pp 40–45

  19. Semlitsch M, Lintner F (1991) Metallische Werkstoffe und deren Oberflächen für direkt am Knochen zu verankernde Hüft-endoprothesenschäfte. Med Orthop Tech 111:60–64

    Google Scholar 

  20. Semlitsch M, Panic B (1983) Ten years of experience with test criteria for fracture-proof anchorage stems of artificial hip joints. Eng Med 12:185–198

    Google Scholar 

  21. Semlitsch M, Weber H (1992) Titanlegierungen für zementlose Huftendoprothesen. In: Hipp E, Gradinger R, Ascherl R (eds) Die zementlose Hüftprothese. Demeter Verlag, Gräfelfrng, pp 18–26

    Google Scholar 

  22. Semlitsch M, Willert HG (1988) Metallic materials for artificial hip joints. (Encyclopedia of medical devices and instrumentation, Vol 1) Wiley, New York, pp 137–149

    Google Scholar 

  23. Semlitsch M, Lehmann M, Weber H, Dörre E, Willert HG (1977) New prospects for a prolonged functional life-span of artificial hip joints by using the material combination polyethylene/aluminium oxide ceramic/metal. J Biomed Mater Res 11:537–552

    Google Scholar 

  24. Semlitsch M, Staub F, Weber H (1985) Titanium-aluminiumniobium alloy, development for biocompatible, high-strength surgical implants. Biomed Tech (Berlin) 30:334–339

    Google Scholar 

  25. Semlitsch M, Streicher RM, Weber H (1989) Verschleißverhalten von Pfannen und Kugeln aus CoCrMo-Gußlegierung bei langzeitig implantierten Ganzmetall-Hüftprothesen. Orthopäde 18:377–381

    Google Scholar 

  26. Semlitsch M, Weber H, Streicher RM, Schön R (1991) Gelenkprothesen-Komponenten aus warmgeschmiedeter und oberflächenbehandelter Ti-6Al-7Nb Legierung. Biomed Tech (Berlin) 36:112–119

    Google Scholar 

  27. Smethurst E (1981) A new stainless steel alloy for surgical implants compared to 316 S 12. Biomaterials 2:1–4

    Google Scholar 

  28. Streicher RM, Schön R, Semlitsch M (1990) Untersuchung des tribologischen Verhaltens von Metall/Metall-Kombinationen für künstliche Hüftgelenke. Biomed Tech (Berlin) 35:107–111

    Google Scholar 

  29. Weber BG (1970) Die Rotations-Totalendoprothese des Hüf-gelenkes. Z Orthop 107:304–315

    Google Scholar 

  30. Weber BG (1981) Total hip replacement: rotating versus fixed and metal versus ceramic heads. Proc. of 9th Hip Society Meeting, pp 264–275

  31. Weber BG (1988) Pressurized cement fixation in total hip arthroplasty. Clin Orthop 232:87–95

    Google Scholar 

  32. Weber BG (1992) Metall-Metall Totalprothese des Hüftgelenkes: Zurück in die Zukunft. Z Orthop 130:257–346

    Google Scholar 

  33. Weber BG, Fiechter T (1989) Polyethylen-Verschleiß und Spätlockerungen der Totalprothese des Hüftgelenkes. Neue Perspektiven für die Metall/Metall-Paarung für Pfanne und Kugel. Orthopäde 18:370–376

    Google Scholar 

  34. Weber BG, Stühmer G, Semlitsch M (1974) Erfahrungen mit dem Kunststoff Polyester al s Komponente der Rotations-Total-prothese des Hüftgelenks. Z Orthop 112:1106–1112

    Google Scholar 

  35. Weber BG, Frey O, Semlitsch M, Dörre E (1977) Aluminiumoxid-Keramikkugeln für Hüftendoprothesen nach Baukastenprinzip. Z Orthop 115:305–309

    Google Scholar 

  36. Weber BG, Semlitsch M, Streicher RM (1993) Total hip joint replacement using a CoCrMo metal-metal-sliding pairing. J Jpn Orthop Assoc 67:391–398

    Google Scholar 

  37. Willert H-G, Semlitsch M (1981) Biomaterialien und orthopädische Implantate. In: Witt AN, Rettig H, Schlegel KF, Hackenbroch M, Hupfauer W (eds) Orthopädie in Praxis und Klinik. Thieme, Stuttgart, pp 22.1–22.53

    Google Scholar 

  38. Willert H-G, Semlitsch M (1990) Wohin geht die Entwicklung der Hüftendoprothetik? Prakt Orthop 2:355–374

    Google Scholar 

  39. Willert H-G, Trammann M (1990) Verlaufskontrollen bei klinischen Problemfällen. In: Zweymüller K (ed) 10 Jahre Zweymüller-Hüftendoprothese. Verlag Hans Huber, Bern, pp 108–113

    Google Scholar 

  40. Willert H-G, Buchhorn GH, Hess T (1989) Die Bedeutung von Abrieb und Materialermüdung bei der Prothesenlockerung an der Hüfte. Orthopäde 18:350–369

    Google Scholar 

  41. Wroblewski BM (1990) Revision surgery in total hip arthroplasty. Springer, Berlin Heidelberg New York, pp 131–138

    Google Scholar 

  42. Zichner L, Willert HG (1992) Comparison of alumina polyethylene and metal/polyethylene in clinical trials. Clin Orthop 282:86–94

    Google Scholar 

  43. Zwicker U, Bühler K, Müller R (1980) Mechanical properties and tissue reactions of a titanium alloy for implant material. Titanium 80, Science and Technology, Proc. 4th Int. Conf. on Titanium, Kyoto, pp 505–514

Download references

Author information

Authors and Affiliations

  1. Sulzer Medical Technology Ltd., Winterthur, Switzerland

    M. Semlitsch

  2. Orthopdäische Universitätsklinik, Robert-Koch-Strasse 40, D-37075, Göttingen, Germany

    H. -G. Willert

Authors
  1. M. Semlitsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. -G. Willert
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Semlitsch, M., Willert, H.G. Implant materials for hip endoprostheses: old proofs and new trends. Arch Orthop Trauma Surg 114, 61–67 (1995). https://doi.org/10.1007/BF00422826

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00422826

Keywords

Search

Navigation