Tan Sok Chuen, Lau Adrian C K, Del Balso Christopher, Howard James L, Lanting Brent A, Teeter Matthew G
Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada; Surgical Innovation Program, Lawson Health Research Institute, London, Ontario, Canada.
J Arthroplasty. 2016 Sep;31(9):2064-71. doi: 10.1016/j.arth.2016.02.027. Epub 2016 Feb 27.
This matched-cohort study aims to compare tribocorrosion between matched ceramic and cobalt-chromium femoral head trunnions and between matched Oxinium and cobalt-chromium femoral head trunnions. Secondary objectives were to investigate whether taper design, depth of trunnion, implantation time, age, body mass index, and gender have an effect on fretting and corrosion.
All hip prostheses retrieved between 1999 and 2015 at one center were reviewed, giving a total of 52 ceramic heads. These were matched to a cobalt-chromium cohort according to taper design, head size, neck length, and implantation time. The trunnions were examined by 2 observers using a 4-point scoring technique and scored in 3 zones: apex, middle, and base. The observers were blinded to clinical and manufacturing data where possible. A separate matched-cohort analysis was performed between 8 Oxinium heads and 8 cobalt-chromium heads, which were similarly scored.
Ceramic head trunnions demonstrated a lower median fretting and corrosion score at the base zone (P < .001), middle zone (P < .001), and in the combined score (P < .001). Taper design had a significant effect on fretting and corrosion in the apex zone (P = .04) of the ceramic group, as well as the cobalt-chromium group (P = .03). Between Oxinium heads and cobalt-chromium heads, there was no significant difference in the fretting and corrosion score across all 3 zones (base: P = .22; middle: P = .92; and apex: P = .71) and for the combined score (P = .67).
This study shows that ceramic head confers an advantage in trunnion fretting and corrosion. Taper design and implantation time were also significant factors for fretting and corrosion.
这项配对队列研究旨在比较配对的陶瓷与钴铬合金股骨头柄以及配对的奥克辛ium（一种特殊材料）与钴铬合金股骨头柄之间的摩擦腐蚀情况。次要目的是研究柄的锥度设计、柄的深度、植入时间、年龄、体重指数和性别是否对微动磨损和腐蚀有影响。
对1999年至2015年间在一个中心取出的所有髋关节假体进行了回顾，共有52个陶瓷头。根据锥度设计、头尺寸、颈长和植入时间将这些陶瓷头与钴铬合金队列进行配对。两名观察者使用4分评分技术对柄进行检查，并在三个区域进行评分：顶端、中部和基部。观察者尽可能对临床和制造数据不知情。对8个奥克辛ium头和8个钴铬合金头进行了单独的配对队列分析，同样进行评分。
陶瓷头柄在基部区域（P <.001）、中部区域（P <.001）以及综合评分（P <.001）方面显示出较低的微动磨损和腐蚀中位数评分。锥度设计对陶瓷组顶端区域（P =.04）以及钴铬合金组顶端区域（P =.03）的微动磨损和腐蚀有显著影响。在奥克辛ium头和钴铬合金头之间，所有三个区域（基部：P =.22；中部：P =.92；顶端：P =.71）以及综合评分（P =.67）的微动磨损和腐蚀评分均无显著差异。
本研究表明，陶瓷头在柄的微动磨损和腐蚀方面具有优势。锥度设计和植入时间也是微动磨损和腐蚀的重要因素。
