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Oxidized Zirconium versus Cobalt-Chromium in TKA: Profilometry of Retrieved Femoral Components

  • Symposium: 2013 Knee Society Proceedings
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Oxidized zirconium (OxZr) was introduced as an alternative bearing for femoral components in total knee arthroplasty (TKA) in an attempt to reduce wear compared with conventional cobalt-chromium (CoCr) alloys.

Questions/purposes

The aim of this study was to compare matched pairs of retrieved OxZr and CoCr components using surface profilometry; specifically, we sought to compare the surface roughness of (1) retrieved OxZr TKA components with retrieved CoCr components; (2) the medial versus the lateral femoral condyles of retrieved components; and (3) unimplanted OxZr TKA components with unimplanted CoCr components.

Methods

Ten retrieved posterior-stabilized Genesis II TKA with OxZr femoral components were identified and matched to retrieved CoCr femoral components by duration of implantation, patient age, and body mass index. A noncontact white light interferometer was used to evaluate surface roughness. One pristine, unimplanted component of each design was analyzed as a control.

Results

The retrieved components showed significantly (p < 0.0001) lower roughness for the OxZr components than the CoCr components. CoCr retrievals showed a significantly greater average surface roughness on the medial condyle. No difference was found between the condyles of the OxZr components. The pristine CoCr implant had a significantly lower surface roughness than the pristine OxZr component.

Conclusions

CoCr roughens significantly more in situ compared with OxZr components.

Clinical Relevance

Bearing surfaces are typically damaged in vivo. The extent of damage is variable between patients and implants; however, rougher surfaces should be associated with more wear. Whether the differences observed in our study prove meaningful requires long-term clinical data.

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Acknowledgments

We thank Kara Fields and Dr Stephen Lyman for their statistical assistance. This work made use of the Cornell Center for Materials Research Shared Facilities, which are supported through the NSF MRSEC program (DMR-1120296).

Author information

Authors and Affiliations

  1. Department of Orthopedics and Rheumatology, University Hospital Marburg, Marburg, Germany

    Thomas J. Heyse MD

  2. Department of Biomechanics, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Marcella E. Elpers BS & Timothy M. Wright PhD

  3. Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA

    Danyal H. Nawabi MD & Steven B. Haas MD

Authors
  1. Thomas J. Heyse MD
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  2. Marcella E. Elpers BS
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  3. Danyal H. Nawabi MD
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  4. Timothy M. Wright PhD
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  5. Steven B. Haas MD
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Corresponding author

Correspondence to Timothy M. Wright PhD.

Additional information

This study was partially funded through a grant from the Marmor Fund of the Adult Reconstruction and Joint Replacement (ARJR) Service of the Hospital for Special Surgery (SBH). Other support was provided by the Clark and Kirby Foundations and The Trump Institute for Implant Analysis (TMW). One or more of the authors certifies that he (TJH) or she, or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount less than USD 10,000, from Smith & Nephew (Memphis, TN, USA). One or more of the authors certifies that he (SBH) or she, or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount more than USD 1,000,001, from Smith & Nephew. One or more of the authors certifies that he (TMW) or she, or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount less than USD 10,000, from Mathys Ltd Bettlach (Bettlach, Switzerland), and an amount USD 10,000–100,000, from Exactech Inc (Great Neck, NY, USA).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the Hospital for Special Surgery, New York, NY, USA.

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Heyse, T.J., Elpers, M.E., Nawabi, D.H. et al. Oxidized Zirconium versus Cobalt-Chromium in TKA: Profilometry of Retrieved Femoral Components. Clin Orthop Relat Res 472, 277–283 (2014). https://doi.org/10.1007/s11999-013-3078-4

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  • DOI: https://doi.org/10.1007/s11999-013-3078-4

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