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Updated: Nov 17 2024

Wear & Osteolysis Basic Science

Images
  • Overview
  • Step 1: Particulate Debris Formation
    • Types of wear
      • adhesive wear
        • most important in osteolytic process
        • microscopically, PE sticks to prosthesis and debris gets pulled off
      • abrasive wear
        • cheese grater effect of prosthesis scraping off particles
      • third body wear
        • particles in joint space cause abrasion and wear
      • volumetric wear
        • main determinant of number of particles created
        • directly related to the radius² of the femoral head
        • volumetric wear more or less creates a cylinder
          • V = 3.14r² x w
            • V is volumetric wear
            • r is the radius of femoral head
            • w is linear head wear
          • head size is most important factor in predicting particles generated
      • linear wear
        • measured by the distance the prosthesis has penetrated into the liner
    • Wear leads to particulate debris formation
      • wear rates by material
        • polyethylene
          • non-cross-linked UHMWPE wear rate is 0.1-0.2 mm/year
            • linear wear rates >0.1 mm/year have been associated with osteolysis and subsequent component loosening
          • highly cross-linked UHMWPE generates smaller wear particles and is more resistant to wear (but has reduced mechanical properties compared to conventional non-highly cross-linked UHMWPE)
            • factors increasing wear in THA
              • thickness <6 mm
              • malalignment of components
              • patients <50 y/o
              • men
              • higher activity level
          • femoral head size between 22-46 mm in diameter does not influence wear rates of UHMWPE
        • ceramics
          • ceramic bearings have the lowest wear rates of any bearing combination (0.5-2.5 µ per component per year)
          • ceramic-on-polyethylene bearings have varied wear rates, ranging from 0-150 µ
          • unique complication of stripe wear occurring from gait with lift-off separation of the head
          • recurrent dislocations or incidental contact of femoral head with a metallic shell can cause "lead pencil-like" markings that lead to increased femoral head roughness and polyethylene wear rates
        • metals
          • metal-on-metal produces smaller wear particles and lower wear rates compared to metal-on-polyethylene bearings (ranging from 2.5-5.0 µ per year)
          • titanium used for bearing surfaces has a high failure rate because of poor resistance to wear and notch sensitivity
          • metal-on-metal wear stimulates lymphocytes
          • metal-on-metal serum ion levels are greater with cup abduction angle >55° and smaller component size
    • Particulate type
      • UHMWPE most common
      • PMMA
      • Co-Cr
      • Ti
      • third body
  • Step 2: Macrophage Activated Osteoclastogenesis and Osteolysis
  • Step 3: Prosthesis Micromotion
  • Step 4: Debris Dissemination
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Recon⎜Wear & Osteolysis, Catastrophic Wear & PE Sterilization (ft. Dr. Javad Parvizi)
  • Recon
  • - Wear & Osteolysis Basic Science
9:40 min
10/18/2019
284 plays
5.0
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(2)
Question Session⎪Wear & Osteolysis Basic Science
  • Recon
  • - Wear & Osteolysis Basic Science
31:1 min
11/5/2019
204 plays
5.0
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Question Session⎜Wear & Osteolysis Basic Science, Catastrophic Wear & PE Sterilization
  • Recon
  • - Wear & Osteolysis Basic Science
47:10 min
11/11/2019
104 plays
3.0
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(2)
Recon⎪Wear & Osteolysis Basic Science
  • Recon
  • - Wear & Osteolysis Basic Science
18:41 min
5/13/2020
1446 plays
5.0
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