Sentuerk U, von Roth P, Perka C
Charité University Hospital Berlin, Charitéplatz 1, 10117 Berlin, Germany.
Bone Joint J. 2016 Jan;98-B(1 Suppl A):14-7. doi: 10.1302/0301-620X.98B1.36347.
The leading indication for revision total hip arthroplasty (THA) remains aseptic loosening owing to wear. The younger, more active patients currently undergoing THA present unprecedented demands on the bearings. Ceramic-on-ceramic (CoC) bearings have consistently shown the lowest rates of wear. The recent advances, especially involving alumina/zirconia composite ceramic, have led to substantial improvements and good results in vitro. Alumina/zirconia composite ceramics are extremely hard, scratch resistant and biocompatible. They offer a low co-efficient of friction and superior lubrication and lower rates of wear compared with other bearings. The major disadvantage is the risk of fracture of the ceramic. The new composite ceramic has reduced the risk of fracture of the femoral head to 0.002%. The risk of fracture of the liner is slightly higher (0.02%). Assuming that the components are introduced without impingement, CoC bearings have major advantages over other bearings. Owing to the superior hardness, they produce less third body wear and are less vulnerable to intra-operative damage. The improved tribology means that CoC bearings are an excellent choice for young, active patients requiring THA.
翻修全髋关节置换术（THA）的主要指征仍然是因磨损导致的无菌性松动。目前接受THA手术的年轻、活动量较大的患者对关节轴承提出了前所未有的要求。陶瓷对陶瓷（CoC）轴承一直显示出最低的磨损率。最近的进展，特别是涉及氧化铝/氧化锆复合陶瓷的进展，已在体外取得了实质性改进和良好效果。氧化铝/氧化锆复合陶瓷极其坚硬、耐刮且具有生物相容性。与其他轴承相比，它们具有低摩擦系数、卓越的润滑性能和更低的磨损率。主要缺点是陶瓷有断裂风险。新型复合陶瓷已将股骨头骨折风险降至0.002%。内衬骨折风险略高（0.02%）。假设组件在无撞击的情况下植入，CoC轴承比其他轴承具有主要优势。由于其卓越的硬度，它们产生的第三体磨损更少，且术中不易受损。改进的摩擦学特性意味着CoC轴承对于需要进行THA的年轻、活动量较大的患者是一个绝佳选择。
