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Welche Hüftgelenkgleitpaarung für welchen Patienten? : Tribologie der Zukunft [Which hip articulation bearing for which patient? Tribology of the future]
Publikationstyp
Journal Article
Date Issued
2011-11-16
Sprache
German
Institut
Journal
Volume
40
Issue
12
Start Page
1061
End Page
1067
Citation
Der Orthopäde 40 (12): 1061-1067 (2011)
Publisher DOI
Scopus ID
PubMed ID
22083422
Publisher
Springer
Replacement of the hip joint has become an exceptionally successful procedure since the inauguration of the low friction principle by Charnley. Aseptic osteolysis and joint dislocation have been addressed by the development of wear-optimized materials and the introduction of larger heads. As an increase in head diameter against polyethylene causes wear increase, larger hard-on-hard bearings were introduced, which exhibit reduced wear and reduced dislocation risk with increasing head diameter. These findings were derived from standard simulator testing, not sufficiently considering the risk of fluid film breakdown under adverse conditions, which can cause a dramatic increase in wear and friction proportional to the head diameter. Such adverse conditions can occur clinically in patients due to several factors and have caused the presently observed unexpected problems with these new designs. Standardized preclinical testing has to be viewed as a minimum requirement but certainly not as a guarantee for the clinical success of new materials and designs even if the testing is adapted to the current patient requirements, which is presently not the case. The future of tribology lies in the prevention of adverse conditions in patients, the improvement and optimized use of proven existing materials and not in the use of new materials. © 2011 Springer-Verlag.
Subjects
Head diameter
Hip joint
Inclination
Resurfacing
Tribology
DDC Class
570: Biowissenschaften, Biologie
610: Medizin