Drexel University, Philadelphia, Pennsylvania.
Exponent, Inc, Philadelphia, Pennsylvania.
J Arthroplasty. 2023 Sep;38(9):1869-1876. doi: 10.1016/j.arth.2023.03.057. Epub 2023 Mar 24.
Little is known about retrieved zirconia platelet toughened alumina (ZPTA) wear particles from ceramic-on-ceramic (COC) total hip arthroplasty. Our objectives were to evaluate clinically retrieved wear particles from explanted periprosthetic hip tissues and to analyze the characteristics of in vitro-generated ZPTA wear particles.
Periprosthetic tissue and explants were received for 3 patients who underwent a total hip replacement of ZPTA COC head and liner. Wear particles were isolated and characterized via scanning electron microscopy and energy dispersive spectroscopy. The ZPTA and control (highly cross-linked polyethylene and cobalt chromium alloy) were then generated in vitro using a hip simulator and pin-on-disc testing, respectively. Particles were assessed in accordance with American Society for Testing and Materials F1877.
Minimal ceramic particles were identified in the retrieved tissue, consistent with the retrieved components demonstrating minimal abrasive wear with material transfer. Average particle diameter from in vitro studies was 292 nm for ZPTA, 190 nm for highly cross-linked polyethylene, and 201 nm for cobalt chromium alloy.
The minimal number of in vivo ZPTA wear particles observed is consistent with the successful tribological history of COC total hip arthroplasties. Due to the relatively few ceramic particles located in the retrieved tissue, in part due to implantation times of 3 to 6 years, a statistical comparison was unable to be made between the in vivo particles and the in vitro-generated ZPTA particles. However, the study provided further insight into the size and morphological characteristics of ZPTA particles generated from clinically relevant in vitro test setups.
从陶瓷对陶瓷（COC）全髋关节置换术中回收的氧化锆板韧化氧化铝（ZPTA）磨损颗粒知之甚少。我们的目的是评估从假体周围髋组织中临床回收的磨损颗粒，并分析体外生成的 ZPTA 磨损颗粒的特征。
为 3 名接受 ZPTA COC 头和衬垫全髋关节置换术的患者接受了假体周围组织和植入物。通过扫描电子显微镜和能量色散光谱法对磨损颗粒进行分离和特征分析。然后，使用髋关节模拟器和销盘测试分别对 ZPTA 和对照物（高度交联聚乙烯和钴铬合金）进行体外生成。根据美国材料试验协会 F1877 标准评估颗粒。
在回收的组织中仅识别出少量陶瓷颗粒，与回收组件显示出的材料转移最小磨损一致。体外研究的平均粒径为 ZPTA 为 292nm，高度交联聚乙烯为 190nm，钴铬合金为 201nm。
在体内观察到的 ZPTA 磨损颗粒数量很少，这与 COC 全髋关节置换术成功的摩擦学历史相符。由于在回收组织中仅存在相对较少的陶瓷颗粒，部分原因是植入时间为 3 至 6 年，因此无法在体内颗粒和体外生成的 ZPTA 颗粒之间进行统计学比较。然而，该研究进一步深入了解了从临床相关体外测试设置中产生的 ZPTA 颗粒的尺寸和形态特征。
