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Several clinical studies of THA inserts showed the benefit of this HXLPE, namely the reduced incidence of osteolysis and reduced wear compared to the conventional polyethylene (CPE) (Kurtz et al. 2011).
Mobile-bearing knee prostheses therefore were designed to provide more conforming surface shapes with reduced polyethylene contact stresses and presumably reduced wear [ 1, 3, 4].
Hip resurface arthroplasty (HRA) has several advantages compared with traditional total hip arthroplasty (THA), including a reduced rate of dislocation due to the larger diameter of femoral head, reduced wear of metal-on-metal interface, a larger range of motion and its bone-conserving nature [ 1- 3].
Newer materials, however, have reduced wear debris.
Increased crosslink density reduced wear by over 60%.
Similarly, decreasing diametral clearance from 90μm to 60μm reduced wear four-fold.
There are several methods and materials available, which offer the potential for significantly reduced wear.
Increasing diameter from 22.225mm to 28mm reduced wear by over an order of magnitude.
Optimized designs yield better performance and reduced wear and fatigue compared to an initial wheel profile.
Effective mixed-film lubrication achieved through careful design and manufacture greatly reduced wear.
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If this is correct, then it would lend support to our hypothesis that inverting the bearing materials reduced wear-induced osteolysis, as we found no notching of grade 3 or 4.
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