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Investigations over the years have shown that the mirror-finished Al2O3 ceramic is a much more suitable frictional counterpart to ultrahigh molecular weight (UHMW) polyethylene than metal. Despite the extremely gread hardness difference between polyethylene and Al2O3 ceramic, a considerable lower wear rate is obtained for the polyethylene socked with this new low-friction material combination. The unexpectedly favorable tribological behavior of this ceramic material in contact with polyethylene may be attributed to the following factors: better values for corrosion resistance characteristics, wettability with liquids, surfact gloss, hardness, and scratch resistance of the ceramic material in comparison with those of the hitherto used metallic implant materials (AISI-316L steel or cast Co-Cr-Mo alloy). It appears that, by using this new combination of materials for the socket and the ball, it will be possible to prolong the service life of artificial hip joints considerably without having effecy any fundamental changes in the present design and implantation principle retaining the hitherto used anchorage shaft made of wrought Co-Ni-Cr-Mo-Ti alloy Protasul-10 of extremely high corrosion fatigue strength.
A 12-channel wear screening device was used to compare the wear properties of a variety of prosthetic joint materials. Two types of tests were run: (1) Ultrahigh molecular weight (UHMW) polyethylene bearing against metal or ceramic counterfaces and (2) various polymers bearing against 316 stainless steel as a standard counterface. Wear was quantified by weighing the polymer specimens, with presoaking and control-soak specimens used to minimize the error due to fluid absorption. The specimens were lubricated with bovine blood serum. Friction and polyethylene wear was very low with each of the metals (316 stainless steel, cobalt-chrome alloy, multiphase alloy, and titanium 6-4 alloy) such that the differences in wear rate would not be significant in terms of choosing a material for clinical application. However, titanium 6-4 alloy was found to be especially susceptible to abrasive wear by particles of acrylic cement. Nitrided titanium 6-4 counterfaces were impervious to acrylic abrasion. Polyethylene wear against highly polished, fully dense ceramics (Sialon, Alumina, Macor, and pyrolytic graphite) was as low as that with the metal counterfaces. Wear increased slightly with increasing ceramic surface roughness. The coefficient of friction of polyethylene against pyrolytic graphite was two to three times higher than with the metals or other ceramics. All of the alternate polymers underwent more wear than UHMW polyethylene. Teflon and polyester, two polymers that have proven unsuccessful in prior clinical use, had wear rates 1,600 and 830 times greater than polyethylene, respectively, an indication that the laboratory wear test provided a quantitative prediction of the behavior of the materials in vivo. However, it was difficult to assess the clinical significance of the less extreme wear rates since the ability of the tissues encapsulating a prosthesis to accomodate wear debris is not known on a quantitative basis.
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