No Difference in Conventional Polyethylene Wear Between Yttria-stabilized Zirconia and Cobalt-chromium-molybdenum Femoral Heads at 10 Years

Abstract

Background

Concerns have arisen regarding deterioration of wear properties of yttria-stabilized zirconia (YSZ) femoral head on conventional polyethylene (PE) bearings due to YSZ phase transformation.

Questions/Purposes

The purpose of this study was to determine if there is a difference in long-term PE wear properties between YSZ and cobalt-chromium-molybdenum (Co-Cr-Mo) femoral heads.

Methods

Ten-year radiographic wear assessment was performed on a cohort of patients enrolled in a prospective randomized clinical trial comparing total hip arthroplasty with YSZ or Co-Cr-Mo femoral heads on conventional, non-cross-linked PE.

Results

PE linear wear, annualized wear, and steady-state wear rates remained low and similar between groups. No cases of osteolysis were observed.

Conclusions

Measured conventional PE wear was similar between YSZ and Co-Cr-Mo femoral heads with the steady-state wear rates for both remaining below the generally accepted threshold at which osteolysis typically occurs. Whether clinically relevant phase transformation with YSZ femoral heads occurs is uncertain; however, the use of YSZ femoral heads in this study was not associated with increased PE wear, osteolysis, or deterioration of wear properties.

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Acknowledgements

We thank Dr. John Martell for his assistance with the radiographic wear analysis and the late Dr. Victor M. Goldberg for his surgical care of some of the study participants.

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Correspondence to Todd A. Morrison MD.

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Conflict of Interest

Todd A. Morrison, MD; Clare M. Rimnac, PhD; Jia Meng, BS; Rebecca D. Moore, MS have declared that they have no conflict of interest. Matthew J. Kraay, MD, MS, reports a grant from Orthopaedic Research Education Foundation (OREF), during the conduct of the study.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

Informed consent was obtained from all patients for being included in the study.

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Level of Evidence: Level II: Randomized Control Trial

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Morrison, T.A., Moore, R.D., Meng, J. et al. No Difference in Conventional Polyethylene Wear Between Yttria-stabilized Zirconia and Cobalt-chromium-molybdenum Femoral Heads at 10 Years. HSS Jrnl 14, 60–66 (2018). https://doi.org/10.1007/s11420-017-9579-z

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Keywords

  • hip
  • wear analysis
  • ceramic
  • polyethylene
  • zirconia