Bal B S, Garino J, Ries M, Rahaman M N
Department of Orthopaedic Surgery, School of Medicine, University of Missouri-Columbia, Columbia, MO 65212, USA.
Hip Int. 2007 Jan-Mar;17(1):21-30. doi: 10.1177/112070000701700105.
Bearings made of ceramics have ultra-low wear properties that make them suitable for total hip arthroplasty (THA) and total knee arthroplasty (TKA). When compared to cobalt chrome (CoCr)-on-polyethylene (PE) articulations, ceramics offer drastic reductions in bearing wear rates. Lower wear rates result in fewer wear particles produced by the articulating surfaces. In theory, this should reduce the risk of periprosthetic osteolysis and premature implant loosening, thereby contributing to the longevity of total joints. In addition to ceramics, other alternative bearing couples, such as highly cross-linked PE (XLPE) and metal-on-metal also offer less wear than CoCr-on-PE articulations in total joint arthroplasty. Alumina and zirconia ceramics are familiar to orthopaedic surgeons since both materials have been used in total joints for several decades. While not new in Europe, alumina-on-alumina ceramic total hips have only recently become available for widespread use in the United States from various orthopaedic implant manufacturers. As the search for the ideal total joint bearing material continues, composite materials of existing ceramics, metal-on-ceramic articulations, and new ceramic technologies will offer more choices to the arthroplasty surgeon. The objective of this paper is to present an overview of material properties, clinical applications, evolution, and limitations of ceramic materials that are of interest to the arthroplasty surgeon.
陶瓷制成的轴承具有超低磨损特性，使其适用于全髋关节置换术（THA）和全膝关节置换术（TKA）。与钴铬（CoCr）对聚乙烯（PE）关节相比，陶瓷的轴承磨损率大幅降低。较低的磨损率导致关节表面产生的磨损颗粒减少。从理论上讲，这应该会降低假体周围骨溶解和植入物过早松动的风险，从而有助于全关节的使用寿命。除了陶瓷，其他替代关节配对，如高交联PE（XLPE）和金属对金属，在全关节置换术中的磨损也比CoCr对PE关节少。氧化铝和氧化锆陶瓷为骨科医生所熟知，因为这两种材料已在全关节中使用了几十年。虽然在欧洲并不新鲜，但氧化铝对氧化铝陶瓷全髋关节直到最近才由各种骨科植入物制造商在美国广泛使用。随着对理想全关节轴承材料的探索仍在继续，现有陶瓷的复合材料、金属对陶瓷关节和新的陶瓷技术将为关节置换外科医生提供更多选择。本文的目的是概述关节置换外科医生感兴趣的陶瓷材料的材料特性、临床应用、发展历程和局限性。
