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Ceramics in Hemiarthroplasty

How cartilage-friendly are ceramics?

Ceramics in hemiarthroplasty. Partial joint replacement aims to restore joint mobility and milder osteoarthritis in the early stages of cartilage degeneration or damages. In such procedures, the implant (shoulder, knee, hip) articulates directly against the native cartilage. In a recently published in-vitro study, Wimmer et al. (Rush University, Chicago (IL)) investigated the wear effects on living cartilage by ZTA ceramic femoral heads (BIOLOX®delta) and CoCrMo heads, respectively. This assessment included also the hydroxyproline release as a sensitive marker for cartilage wear.

Results: After 10 days of testing, both groups (each with 12 femoral heads) showed 80% of cell survival. The setup involving the ZTA heads-on-cartilage induced lower hydroxproline and less cartilage cell and tissue damage than the CoCrMo heads-on-cartilage set up allowing the conclusion that BIOLOX®delta ceramic femoral heads are more cartilage-compatible than CoCrMo heads despite a similar roughness.

Reference: Wimmer MA, Pacione C, Yuh C, et al. Articulation of an alumina-zirconia composite ceramic against living cartilage - An in vitro wear test. J Mech Behav Biomed Mater. 2020;103:103531. doi:10.1016/j.jmbbm.2019.103531.

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