翻修膝关节假体上陶瓷涂层的稳定性

Stability of ceramic coatings on retrieved knee prostheses.

作者信息

Bormann Therese, Kraenzler Simeon, Jaeger Sebastian, Kluess Daniel, Mittelmeier Wolfram, Renkawitz Tobias, Kretzer J Philippe

机构信息

Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.

出版信息

J Mech Behav Biomed Mater. 2023 Aug;144:105997. doi: 10.1016/j.jmbbm.2023.105997. Epub 2023 Jul 3.

DOI:10.1016/j.jmbbm.2023.105997

PMID:37413893

Abstract

BACKGROUND

In total knee arthroplasty, femoral components with coated or oxidized surfaces are commonly used as alternative to CoCrMo in metal sensitive patients. Data on the in vivo behaviour of different coating types is, however, rare. Aim of the study was the investigation of coating stability with respect to implant and patient specific parameters.

METHODS

Coating thickness and coating thickness reduction, respectively, was measured at 37 retrieved femoral components with TiNbN, TiN, ZrN or oxidized zirconium (OxZr) surface by the crater grinding method. The results were correlated to surface type, manufacturer, time in vivo of the implant, patient body weight and patient activity.

RESULTS

Mean coating thickness reduction in the overall retrieval collection was 0.6 μm ± 0.8 μm. There was no correlation between coating thickness reduction and coating type, time in vivo, patient body weight, and patient activity. If grouped according to manufacturers, implants of one manufacturer showed an increased coating thickness reduction. 10 of 37 retrievals exhibited coating abrasion with exposure of the underlying alloy. TiNbN coatings showed the highest incidence (9/17) of coating abrasion. No coating breakthrough was observed in the ZrN or OxZr surfaces.

CONCLUSION

Our results indicate that TiNbN coatings should be optimized to improve their wear resistance in the long-term.

摘要

背景

在全膝关节置换术中，对于金属敏感患者，具有涂层或氧化表面的股骨假体通常被用作钴铬钼合金假体的替代品。然而，关于不同涂层类型在体内行为的数据却很少。本研究的目的是针对植入物和患者特定参数研究涂层稳定性。

方法

采用坑磨法对37个回收的具有TiNbN、TiN、ZrN或氧化锆（OxZr）表面的股骨假体测量涂层厚度及涂层厚度减少量。将结果与表面类型、制造商、植入物的体内时间、患者体重和患者活动情况相关联。

结果

在整个回收样本中，涂层平均厚度减少量为0.6μm±0.8μm。涂层厚度减少量与涂层类型、体内时间、患者体重和患者活动情况之间均无相关性。若按制造商分组，其中一个制造商的植入物涂层厚度减少量增加。37个回收样本中有10个出现涂层磨损且底层合金暴露。TiNbN涂层的涂层磨损发生率最高（9/17）。在ZrN或OxZr表面未观察到涂层穿透。