cadera / hip - Active Congress.......

MARTES / TUESDAY
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7. Greer K.W., Hamilton J.V., Cheal E.J,
“Polyethylene wear in orthopaedics” in
Encyclopaedic Handbook of biomaterials
and bioengineering, Part B: Applications,
Volume 1, (DL.Wise et alumina; editors),
Marcel Dekker, Inc., pp. 613-638, 1995.
8. Plitz W., Walter A., “Tribological aspects
of metal/polymer couplings”, in Technical
principles, design and safety of joint
implants (G. Buchhorn, H-G. Willert,
eds.), Hogrefe &Huber Publishers, 82-
89, 1994.
9. Algan S.M., Horowitz S.M., “Biology of
aseptic loosening of the cemented arthroplasty”
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B: Applications, Volume 1, (DL.Wise et
alumina; editors), Marcel Dekker, Inc., pp.
773-797, 1995.
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Toni A., “Discussion on the design of a hip
joint simulator”, Med. Eng. Phys. 18, No.3,
234-240, 1996.
11. Ben Abdallah A., Treheux D., “Friction
and wear of ultrahigh molecular weight
polyethylene against various new ceramics”,
Wear 142, 43-56, 1991.
12. Suh N., Mosleh M., Arinez J., “Tribology
of polyethylene homocomposites”, Wear
214, 231-236, 1998.
13. Streicher M., “Tribology of artifi cial joints”,
in “Endoprosthetics” (E. Morscher, editor),
Springer Verlag, 1995.
ALTERNATIVE BEARING
MATERIALS:
HIGHLY CROSS-LINKED
POLY/METAL ON METAL/
CERAMIC ON CERAMIC
D. A. Dennis, M.D.
Adjunct Professor, Dept. of Biomedical
Engineering, University of Tennessee
Assistant Clinical Professor, University
of Colorado Health Sciences Center
Clinical Director, Rocky Mountain Musculoskeletal
Research Laboratory
Denver, Colorado, USA
I. Bearing Surfaces and Wear Particle-Induced
Osteolysis
A.The Problem
- Improved fi xation of implants in the 1980’s
has unmasked another limitation of THA…
wear particle induced osteolysis
“The presence of macrophages at the interface
is a tissue response that no implant
surgeon can lightly dismiss.” 32
- Production of osteolytic mediators and
metabolic byproducts by histiocytes is
stimulated by phagocytosis of particulate
debris. 7,72,86,100,102
• Particulate biomaterials including the
articulating surface, bone cement, and
porous metal fi xation surfaces have all
been implicated. 7,86,124,125,174,175
• Ultra-High Molecular Weight Polyethylene
is now widely perceived as the most
signifi cant particle in wear induced bone
resorption and the ultimate cause of failure
of many implants. 7,86,124,125,174,175
• How much polyethylene wear is too
much?
• Osteolysis is associated with linear wear
rates >0.2mm/year in both cemented
THA 149,218 and cementless THA 208,216
• Minimal osteolysis when linear wear <
0.1mm/year 149,208,216,218