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Review of wear mechanisms in hip implants: Paper I General

A. Buford
a
, T. Goswami
b,
*
a
Department of Mechanical Engineering, 1815 Coliseum Drive, Russellville, AR 72801, USA
b
Department of Mechanical Engineering, Ohio Northern University, Ada, OH 45810, USA
Received 6 June 2003; accepted 28 November 2003
Abstract
A review of wear mechanisms has been carried out in this paper for the hip prostheses. The primary causes of premature failure in
hip prostheses are due to wearing of the implants. Multiple variables interact and increase the resultant wear rates. A summary of
clinical in vivo and bulk material wear rate data from published literature has been presented for polyethylene-on-metal, metal-on-
metal, and ceramic implants. This article addresses the engineering aspects concerning the advantages and disadvantages of each
type of articulation. Wear mechanisms are discussed as a function of contact stresses, lubricants and clearance, surface hardness and
roughness, type of articulation due to motion, number of cycles, solution particle count and distribution, oxidation of materials, and
surface abrasions of both metal and polyethylene particulates. These issues are reviewed in this review.
2003 Published by Elsevier Ltd.
Keywords: Wear rates; Bearing surfaces; Ultra high molecular weight polyethylene, UHMWPE; Metal-on-metal; Ceramic; Debris
1. Introduction
Prevention of premature failure of orthopeadic hip
implants has been a constant struggle for physicians and
engineers. Over 40 years ago, Sir John Charnley, pre-
dicted that there would never be an articial hip joint
that would last thirty years while enduring a highly ac-
tive, athletic life. Charnleys statement is true as of the
present day because the lifespan of hip implants is sig-
nicantly lower than 30-year goal set by the orthopaedic
community [1]. With an increasing demand for pros-
thesis hip implantation, there is an increasing need for a
more wear resistant implant design. A growing number
of hip prostheses is being installed in younger, more
active patients. In the year 2000, approximately 500,000
total hip replacements were performed in the United
States alone and 11% of recipients were within the age
group of 40 years. Given that this trend will continue, 40
million people will be in the 40-year age group by 2010
needing more implants. The hip prosthesis designs,
currently used in implantation, result in wearing of the
implant at articulating contact areas. In order for the
implants to be more durable, all the factors that inu-
ence wear and its rates must be studied to obtain opti-
mal combinations of design variables.
From a select group of publications referenced here
[126], multiple factors were found to inuence wear
rates. These factors include, type of materials, contact
stresses, surface hardness and roughness, type of artic-
ulation due to motion, number of cycles, solution par-
ticle count and distribution, oxidation of materials, and
surface abrasions of both metal and polyethylene par-
ticulates. This paper combines previous studies of wear
of both metal-on-metal and metal-on-polyethylene im-
plants and provides a summary of the laboratory gen-
erated results on bulk materials. The objective of this
paper is to identify variables and how each variable in-
uences the wear rates of the implants.
2. Polyethylene on metal implants
Metal paired with polyethylene implants are most
widely used prosthesis in implant design. Polyethylene
implants are highly susceptible to wear that leads to
osteolysis, a leading cause of failure in total hip
*
Corresponding author. Tel.: +1-419-772-2385; fax: +1-419-772-
2404.
E-mail address: t-goswami@onu.edu (T. Goswami).
0261-3069/$ - see front matter 2003 Published by Elsevier Ltd.
doi:10.1016/j.matdes.2003.11.010
Materials and Design 25 (2004) 385393
www.elsevier.com/locate/matdes
Materials
& Design
arthroplasty. Osteolysis is the byproduct of the contin-
uous wearing of the implants due to cyclic loading, re-
sulting from continuously increasing particulate
formation that causes inammatory tissue response and
may ultimately lead to removal of the implant. There are
many design factors that inuence the wear in polyeth-
ylene. Therefore, how each factor aects the wear of the
prosthesis is very important in design. The polyethylene-
on-metal wear factors include: type of material, type of
polyethylene, kinematical contact stresses, articulation,
oxidation, lubricants and clearances. Various factors,
inuencing wear rates are summarized in Table 1 [2].
2.1. Combination of implant materials
Dierent combinations of polyethylene with metal
alloys, and ceramics produce dierent wear rates. These
wear rates are a result of the dierent material proper-
ties. For example, one unique characteristic of ceramic
materials is, unlike metal alloys, ceramics do not form
an oxidative coating that leads to oxidative wear.
Among the material properties of interest are hardness,
roughness, and ability to resist particulate formation
and their sizes.
2.2. Metal alloys paired with polyethylene
Brummitt et al. [3] studied retrieved implants con-
sisting of both titanium and cobalt chromium (CoCr)
alloys. The cobaltchromium alloys showed superior
wear resistance after twelve years in vivo use compared
to the titanium alloys that were signicantly damaged
before twelve years. Both metal alloys were combined
with the same ultra high molecular weight polyethylene
(UHMWPE) components. The surface nish of cobalt
chromium alloy was maintained uniformly over the ar-
ticulation zones; however, the titanium implants were
uniformly damaged. The roughness measurements [3],
R
a
, for both types of alloys are shown in Table 2. The
average roughness values from the three tests conducted
on the specimens are shown in Fig. 1 [3]. Although the
implants were removed from dierent patients with
dierent life styles that aected the wear rates, the wear
rates in cobaltchromium alloys were signicantly lower
than the titanium alloys in both cases.
Davidson et al. [4] determined CoCrMo was a su-
perior alloy. The experiment dealt with many types of
alloys and provided data on the material properties and
how these properties aected the amount of wear on the
metal-polyethylene implants. The data from [4] are
shown in Table 3. The CoCrMo had the highest re-
sistance to bone debris formation out of all the metal
polyethylene combinations [4] as shown in Fig. 2.
A clinical study by Urban et al. [5] compared dierent
materials and wear of hip implants over a period be-
tween 17 and 21 years. The materials, combined with
polyethylene, were evaluated in this study included
stainless steel, cobalt chromium alloys, and ceramics.
The metal-on-polyethylene results are shown in Table 4
[511]. There were no signicant dierences in the av-
erage wear rate per year between the stainless steels and
the cobaltchromium alloys.The ceramicpolyethylene
results, [5,7,10,1215] Table 5, show that the ceramic
Table 1
Summary of factors inuencing polyethylene wear
Factor Increasing wear Decreasing wear
Age Younger Older
Activity level High Low
Head size (mm) 32 26 or 28
Fixation Bone Cement
Prothesis Ti CoCr
Liner thickness (mm) <8 >8
Femoral oset Not restored Restored
Head type
Ti Likely
Table 2
Comparison of R
a
value with instruments
Material Inter
ferometer
Mechanical
prolometer
Laser
prolo
meter
Average of
three tests
Worn Ti alloy 0.101 0.081 0.273 0.152
Worn Ti alloy 0.091 0.093 0.448 0.211
Worn CoCr 0.016 0.034 0.152 0.067
Worn CoCr 0.006 0.021 0.108 0.045
0.152
0.211
0.067
0.045
0.000
0.050
0.100
0.150
0.200
0.250
1
Alloy Types
R
o
u
g
h
n
e
s
s

V
a
l
u
e
s
Worn Ti alloy
Worn Ti alloy
Worn Co-Cr
Worn Co-Cr
Fig. 1. Average roughness of materials.
Table 3
Surface roughness of various metals
Material Surface
hardness
(DPH)
Wear
depth
(mm)
Increase
in R
a
(mm)
Number
of wear
(cycles)
316L S.S. 230 48 0.74 10
6
Ti6AL4V 330 28 4.09 10
6
Nitrogen ion implanted
Ti6Al4V 700 31 3.25 10
6
CoCrMo 400 1 0.1 10
6
ZrO
2
1430 0 0 10
7
Note. Ra Roughness value.
386 A. Buford, T. Goswami / Materials and Design 25 (2004) 385393
materials possessed superior wear resistance as com-
pared to metal alloys; however, the ceramic materials
are historically susceptible to fracture. In the last 10
years, the failure rate of ceramic femoral heads had
reached 13.4%, such high failure rates were addressed by
altering the manufacturing processes and increasing
fracture resistance thereby, lowering the failure rate to
02.0% [4]. The average linear wear rate for each type of
material was calculated and is shown for comparison [5]
in Fig. 3.
Many factors inuence the wear rates of implants. A
wear mechanism is classied as any mechanism that
causes a change in wear rates. The wear rate is deter-
mined by the amount of wear that the implant endures
with respect to time, and is commonly measured by
volumetric loss. It is important to understand that lower
wear rates for certain materials may have been achieved
because of the combination of other factors in a given
scenario. Therefore, it is necessary to perform statistical
analysis on the wear factors to develop a correlation
between a given wear factor and wear rate. Sychterz
et al. [16] conducted statistical study on 19 retrieved
implants. The statistical analysis was used to determine
if cobaltchromium heads were signicantly superior to
ceramic femoral heads when paired with a polyethylene
cup. The study concluded that there was no correlation
to wear rates between the cobaltchromium and ce-
ramics, nor was there a direct relationship to wear
caused by the sex of the patient or the head type,
modular or non-modular [16].The physical properties of
the retrieved implants are shown in Table 6. The wear
rates and test variables for the retrieved implants are
shown in Table 7 [16].
The dierent types of alloys and ceramics combined
with the dierent types of polyethylene result in varied
wear rates. The cobalt chromium alloys and ceramic
materials, used in polyethylene-on-metal implants, have
proved superior in wear resistance as compared to pre-
vious metals used in total hip arthroplasty designs. The
wear rate shown in these tables are a function of head
diameters used.
3. Polyethylene type
UHMWPE has been paired with metal implants for
several years. This polyethylene has been more wear
resistant than other types because UHWMPE has be-
tween 45% and 65% less crystalline structure than other
types of polyethylene resulting in a tougher, more duc-
tile material. However, this structure is more susceptible
to creep due to body temperature, and is more uid
absorbent [17]. Much like the dierent metal alloys used
in implants, there are also many forms of UHMWPE as
well as manufacturing processes that aect the proper-
ties of the material. These processes include: heat
Table 5
Wear rates of ceramic-on-polyethylene total hip replacements
Refer-
ences
Acetabular
bearing
Femoral
bearing
Femoral
head
Average
liner
Diameter
(mm)
Wear rate
(mm/yr)
[14]
a
Polyethylene Alumina 28 0.10
[15]
a
Polyethylene Alumina 28 0.10
[10] Polyethylene Alumina 28 0.08
[12] Polyethylene Alumina 32 0.03
[7] Polyethylene Alumina 28 0.03
[13] Crossed-linked
poly
Alumina 22 0.03
a
Same group of patients.
Table 4
Wear rates of metal-on-polyethylene total hip replacements
Refer-
ences
Acetabular
bearing
Femoral bearing Femoral
head
Average
liner
Diameter
(mm)
Wear
rate
(mm/yr)
[9] Polyethylene
a
Cobaltchromium 28 0.14
[10] Polyethylene Stainless steel 22 0.14
[6] Polyethylene Stainless steel 22 0.13
Polyethylene Cobaltchromium 32 0.10
Polyethylene Stainless steel 28 0.08
[8] Polyethylene
a
Stainless steel 22 0.09
[11] Polyethylene
a
Cobaltchromium 28 0.05
[7] Polyethylene Cobaltchromium 32 0.04
Polyethylene Stainless steel 28 0.04
a
Cemented all-polyethylene component.
0
10
20
30
40
50
m
1
Alloy Type
316L S.S.
Ti-6AL-4V
Nitrogen ion Implanted
Ti-6Al-4V
Co-Cr-Mo
ZrO2
Fig. 2. Wear depth in various biomaterials.
0
0.02
0.04
0.06
0.08
0.1
(
m
m
/
y
r
.
)
Materials
Cobalt-Chromium
Stainless Steel
Ceramic (Alumina)
Fig. 3. Average linear wear rate for three materials.
A. Buford, T. Goswami / Materials and Design 25 (2004) 385393 387
pressing, polishing, gamma irradiation, carbon rein-
forced polymer chains, and pressure crystallization,
which have provided both higher and/or lower wear
rates.
High-pressure crystallization was implemented in
design to improve fatigue crack growth and creep re-
sistance. However, this process did not alter signicantly
the wear rates in polyethylene [18]. Increasing the crys-
tallinity of polyethylene causes an increase in the poly-
ethylenes modulus of elasticity resulting in more intense
contact stresses. If the contact stresses are unevenly
dispersed, the wear rate of the polyethylene will increase
[19]. Subsurface delamination has been determined to be
a detrimental byproduct of the heat pressed polyethyl-
ene surfaces. This delamination has been determined to
lead to premature cracking of the surfaces.
Carbon reinforced polymer chains are used to make
the bearing material stronger and tougher; however,
carbon reinforced polymers caused increased wear due
to less conformed articulating surfaces and higher con-
tact stresses [17]. The carbon bers blended with poly-
ethylene, enhanced its creep resistance by lowering or,
with no improvement in failure resistance. Gamma ir-
radiation is now being tested to determine if this process
will benecially alter the properties of polyethylene.
Some of the prospective benets of gamma irradiating
polyethylene include a more eective cross linking, and
eliminating the eects of oxidation on the polyethylene
[20].
4. Contact stresses and articulation
The articulation type and contact stresses develop as
a result inuence wear rates of an implant. Many tests
have been performed on implants to evaluate the ar-
ticulating and contacting areas to decrease wear rates.
Dierent types of articulating motions produce multi-
ple types of contact stresses. Contact stresses can be
divided into three basic categories: sliding, gliding, and,
rolling.
Sliding is classied as a motion caused by the relative
contact position of the polymer that remains stationary.
Gliding is where the contact position in the polymer
reciprocates. Rolling occurs when the contact position
on the polymer varies and the relative velocities of both
components are equal [21]. Often there is more than one
type of kinematic contact stress in an implant design,
and therefore it is necessary to understand each type and
how the three types inuence wear rates.
Cornwall et al. [21] studied the three types of
kinematic contact stresses and the results are shown in
Table 8. The CoCr alloys paired with ultra high mo-
lecular weight polyethylene show that the sliding contact
Table 6
Data on the patients and components
Specimen No. Gender, age of
patient (yr)
Weight of patient at
time of Op. (kg)
Duration that
implant was in situ
(Mos.)
Femoral head Modular head
1R M, 69 81.6 62 Ceramic Yes
2L M, 62 74.8 112 Cobaltchromium No
2R 62 74.8 110 Cobaltchromium No
3L F, 71 61.2 92 Cobaltchromium No
4R M, 71 73.0 45 Cobaltchromium Yes
5L F, 77 86.2 66 Cobaltchromium No
5R 75 79.4 91 Cobaltchromium No
6R F, 87 60.8 75 Cobaltchromium No
7L M, 50 88.4 116 Cobaltchromium No
8L F, 66 54.9 51 Ceramic Yes
9R M, 79 81.6 151 Cobaltchromium No
10L F, 39 45.4 97 Cobaltchromium No
10R 43 45.4 56 Ceramic Yes
11L M, 78 76.2 42 Cobaltchromium Yes
12L F, 62 59 52 Cobaltchromium No
12R 63 62.6 44 Cobaltchromium No
13R F, 77 65.8 132 Cobaltchromium No
14L M, 70 86.6 206 Cobaltchromium No
14R 69 83.9 123 Cobaltchromium No
15R F, 76 47.2 33 Cobaltchromium Yes
16L F, 84 56.7 144 Cobaltchromium No
16R 83 56.7 156 Cobaltchromium No
17R M, 73 107.5 75 Ceramic Yes
18R F, 81 69.8 83 Cobaltchromium No
19L M, 76 74.8 53 Cobaltchromium Yes
19R 73 75.7 88 Ceramic Yes
Note. M male, F female.
388 A. Buford, T. Goswami / Materials and Design 25 (2004) 385393
stress was superior in both test cases. There were two
sliding tests conducted that produced two very dierent
results. The Sliding A test was recommended by ASTM,
and used a at pin in the contact area unlike the
spherical pin used in the Sliding B test that resulted in a
signicantly lower wear rates. A comparison of average
wear rates for the types of kinematic contact stresses is
shown in Fig. 4. High contact stresses are generally
thought to be detrimental to the prosthesis, but these
stresses were tested and found to be complimentary to
the prosthesis. Wang et al. [22] concluded that an in-
crease in maximum contact stress resulted in lowering
the coecients of friction and a decrease in wear rates.
These results were contradictive to many previous the-
oretical studies.
The eects of these types of contact stresses are bur-
nishing, pitting, fretting, and scratching. Burnishing is
the most common type of polyethylene wear and is
classied by a rubbing, polishing motion [23]. The other
forms of polyethylene wear are very similar and all re-
sult in the detrimental deformation of the prosthesis
joint. Articulation is the junction of a joint with bones
and cartilage. In a prosthesis hip implant, this articula-
tion must be reproduced with non-biological materials
that mimic the natural motion of the human hip joint.
The implant materials, unlike the human body are not
capable of remodeling. In order to design a durable
implant it is important to understand the articulation
process and how wear mechanisms inuence wear. The
three main forms of wear mechanism are adhesion,
Table 8
Mean wear loss, wear rate, and wear factor for the dierent test congurations after 3 10
6
cycles of testing
Testing
conguration
n Contact stress
(MPa)
Mass loss (mg) Wear rate (mm
3
/10
6
) Wear factor (mm
3
/Nm)
Average SD Average SD Average SD
Sliding A 5 3 1.452 1.571 0.523 0.573 6:811 10
8
7:0886 10
8
Sliding B 3 32 0.101 0.058 0.036 0.021 5:289 10
9
3:3651 10
9
Gliding C 3 32 3.390 0.546 1.217 0.203 1:867 10
7
3:2107 10
8
Rolling D 3 2232 4.589 3.227 1.643 1.152 2:515 10
7
1:7603 10
7
Note. SD Standard deviation; n number of test.
Table 7
Data on wear
Specimen
No.
Linear wear
(mm)
Volumetric wear
(mm
3
)
Rate of linear wear
(mm/yr)
Rate of volumetric
(mm
3
/yr)
Angle from face of
cup
a
Angle from superior
point
b
1R 0.32 216.1 0.06 41.8 34.8 )97.1
2L 0.41 300.1 0.04 32.2 43.4 168.0
2R 0.80 561.7 0.09 61.3 39.3 81.5
3L 0.40 238.6 0.05 31.1 22.7 58.1
4R 0.63 492.5 0.17 131.3 59.7 21.4
5L 0.36 232.1 0.07 42.2 29.3 0.1
5R 0.18 116.1 0.02 15.3 28.0 )4.0
6R 0.24 183.5 0.04 29.4 57.0 42.8
7L 0.30 199.0 0.03 20.6 31.7 31.0
8L 0.30 176.9 0.07 41.6 21.0 )139.4
9R 0.28 13.0 0.02 1.0 )52.0 )82.0
10L 0.82 24.6 0.10 3.0 )57.2 )16.4
10R 0.26 149.9 0.05 32.1 21.6 )47.5
11L 0.32 119.4 0.09 34.1 )2.9 143.3
12L 0.40 259.3 0.09 59.8 29.2 )53.7
12R 0.41 211.6 0.11 57.7 13.5 48.2
13R 0.74 484.6 0.07 44.1 31.6 62.2
14L 0.78 305.1 0.05 17.8 )1.5 66.3
14R 0.21 111.2 0.02 10.9 15.4 25.6
15R 0.49 189.6 0.18 68.9 )2.1 12.2
16L 0.47 281.2 0.04 23.4 22.6 80.1
16R 0.39 34.9 0.03 2.7 )41.6 )130.4
17R 1.07 779.1 0.17 124.7 43.7 35.5
18R 0.58 412.7 0.08 59.7 40.5 13.0
19L 0.17 106.6 0.04 24.1 29.2 25.1
19R 0.24 179.6 0.03 24.5 45.7 12.4
a
A negative angle indicates a lateral wear vector.
b
Negative angles are directed anteriorly and positive angles are directed posteriorly.
A. Buford, T. Goswami / Materials and Design 25 (2004) 385393 389
abrasion, and fatigue. These factors are responsible for
causing wear modes that are used to classify wear as a
function of an implants life [23]. These modes of failure
can be summarized into four categories.
Mode 1 refers to the articulation between the primary
contact areas of the prosthesis bearing that is considered
in the implant design. Mode 2 is classied as the surface
abrasion resulting from excessive wear and ultimately
penetration of the primary contact areas in Mode 1 that
was not considered in the initial design. Mode 3 is the
particulate wear caused by the suspended wear particles
in the articulating zone that increase wear rates because
of increased roughness and friction. Mode 4 is the sur-
face rubbing of non-bearing surfaces rubbing together
such as xation pieces that result in fretting. Mode 1 is
essential for the implant to function properly; however,
the other modes are simply destructive byproducts due
to cyclic fatigue loading caused by articulation [23].
Duration and intensity are two important factors that
are related to articulation and aect wear rates. Bowsher
and Shelton [24] studied dierent types of movements
that a hip implant would perform, and the wear rates
that were produced were analyzed. These motions in-
cluded walking, stumbling, and jogging. Each motion
was conducted in both a smooth and a rough condition
[24]. It was shown [24] that the increased speed of run-
ning motion resulted in an increased wear rate. The
rougher condition also increased the wear rates as
compared to the smooth conditions. The stumbling
motion produced the highest frictional torques on the
implant, up to 64% higher than walking. The stumbling
motion also increased the wear rate 1160% higher than
the wear rates for walking motion [24]. Body weight and
standing on one foot also plays a part in the develop-
ment of contact stresses. Standing on one foot can in-
crease stresses several folds and therefore the wear rates.
5. Oxidative wear
When a foreign material is inserted into a biological
mass it is crucial that the material is compatible with the
body. Metals, unlike ceramics, react with the oxygen rich
biological environment, and form a thin protective oxi-
dative coating that prevents corrosion. A thin, trans-
parent coating is generally 25 nm thick [3]. The
oxidative lm forms instantly once exposed to the in vivo
conditions, but are not permanently xated on the met-
als. The coatings are capable of being scratched or rub-
bed o when undergoing surface contact. Once the
coating is dissipated, the implant metals are susceptible
to releasing metal ions and particulates. The presence of
the particulate and ions creates third body wear that
dramatically increases wear rates due to the substantial
increase in roughness. This detrimental cycle applied on
the coating, metal ions released, and reformation of new
coatings is referred to as oxidative wear [4]. Davidson
et al. conducted laboratory tests to determine the
material consistency of particulate caused by oxidative
wear for the most commonly used implant materials. The
particulate formations of various types of implant ma-
terials used in design are shown in Table 9 [4]. While
metallic implants show ion release of various types,
Table 9
Metal levels produced after 1:1 10
5
articulation cycles of various femoral heads against UHMWPE
Material Condition Fe Ni Co Cr Ti Al Zr
316 S.S. Plain 830 190 100
Nitrogen ion implanted 250 95 50
COCrMo Plain 80 25
Nitrogen ion implanted 130 65
Ti6Al4V Plain 160 30
Nitrogen ion implanted 185 35
Al
2
O
3
BIOLOX
a
(Feldmuhle) 0
ZrO
2
Yttria stabilized 0
PROZYR
b

ZrO
2
Monoclinic 0
Note. Units in ng/ml.
a
Cerasir GmbH, Plochingen, Germany.
b
Ceramiques Techniques Desmarquest, Evrenx, France.
0.523
0.036
1.217
1.643
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
Type of Kenimatic Contact
(
m
m
3
/
1
0
6
)
Sliding A (ASTM)
Sliding B
Gliding C
Rolling D
Fig. 4. Kinematic contact versus average wear rate plot.
390 A. Buford, T. Goswami / Materials and Design 25 (2004) 385393
ceramics show no signs thereof. The highest ion release
was shown by stainless steel (SS 316). The metal levels
contained in the serum, simulating the biological uids
contained around the bearing surfaces of the hip joint,
were also measured and shown in Table 10.
6. Lubrication and clearance
In any type of bearing joint, the role of lubrication
and clearance between the articulating surfaces is very
important. The average hip prosthesis is subjected to
approximately three million cycles per year, depending
on the patients activity level, and therefore must be
properly lubricated at an ideal operating clearance. If
the bearing joint of the prosthesis is not suciently lu-
bricated, it would result in increased friction, wear rates,
and particulate count. When considering diameteral
clearance, there must be clearance in order for the joint
to move adequately; however, excess clearance result in
rough, non-uniform rotation of the joint.
Many tests have been conducted to establish how
lubricants aect wear rates. Wang et al. [22] found that
uid lm lubricants were not signicantly inuential in
lubricating the metal on polyethylene joints [22]. The
study also concluded that lower radial clearances re-
sulted in lower coecients of friction, at various load-
ing, and therefore less wear [22].
6.1. Metal-on-metal hip implants
Because of the high wear rates encountered with
metal-on-polyethylene implants metal-on-metal implant
designs are currently being tested. Metal-on-metal im-
plants, much like polyethylene-on-metal implants, have
numerous factors that contribute to wear of the implant.
Many variables cause increased wear rates in polyeth-
ylene-on-metal implants have the same aect on metal-
on-metal implants such as lubricants, oxidative wear,
articulation, and contact stresses.
6.2. Materials
The combinations of materials used aect metal-
on-metal implants, just like polyethylene-on-metal
implants. CoCr alloys are used extensively for metal-
on-metal implants. However, each type of CoCr alloy
has dierent properties that aect the wear rates of the
implant. These properties include percent carbon,
manufacturing process, and surface nish. High carbon
alloys have an average initial wear of 0.21 mm
3
for the
cast implants and 0.24 mm
3
for the wrought implants
(per one million cycles). The low percent carbon alloys
had a signicantly greater wear rate of 0.76 mm
3
. The
high percent carbon alloys showed superior wear resis-
tance as compared to the low percent carbon alloys with
the assumption that there was no additional variation in
other parameters [25]. The properties of the implants
tested are shown in Table 11 and the results are shown
Table 10
Metal levels from various articulation combinations in serum after 1 10
5
Cycles
Head material Cup Fe Ni Cr Co Ti Al
316 S.S. UHMWPE 236
a
54 30
a

CoCrMo UHMWPE 47 154
CoCrMo CoCrMo 2420 11,110
Ti-6Al-4V UHMWPE <330
b
<2.5
b
Note. Units in ng/ml.
a
Estimated based on Fe/Ni and Cr/Ni ratios.
b
Detection limit.
Table 11
Specications of CoCrMo hip implants
Test No.
a
Material Diametral
clearance
(lm)
Surface
roughness
(Head)
(nm)
1 F1537-94 low carbon 101.6 5.3
2 101.6 6
3 101.6 8
4 101.6 7.8
5 106.7 9.4
6 106.7 9.2
7 86.4 13.5
8 96.5 5.7
MeanSD 100.3 6.5 8.1 2.7
9 F1537-94 high carbon 71.3 19.8
10 66 10
11 76.2 6
12 76.2 4.6
13 66 2.1
14 35.6 3
MeanSD 65.2 15.2 7.6 6.6
15 F75-92 high carbon 30.5 7.2
16 45.7 5.8
17 71.1 7.3
18 81.3 6.4
19 10.2 12.7
20 40.6 6.8
21 86.4 5
22 86.4 7.6
MeanSD 56.5 28.8 7.4 2.3
Note. Average CLA surface roughness head (nm). CLA centerline
average; SD standard deviation.
a
Test numbers correspond to those from [25].
A. Buford, T. Goswami / Materials and Design 25 (2004) 385393 391
in Table 12 [25]. Other tests conrm high percent car-
bons have superior wear resistance indicating that the
high percent carbon cups articulating with the high
percent carbon heads produced the lowest wear rates
[25].
The type of manufacturing process also has an eect
on the wear rates. The current study determined that the
casting technique was superior to the wrought tech-
nique. The average linear wear values for casting was
0.43 mm
3
as compared to the wrought value of 0.61
mm
3
. The dierence in wear rates for the two manu-
facturing processes was small and considered insigni-
cant [25].
7. Metal-on-metal implants
Multiple tests show that the metal-on-metal implants
are superior against wear as compared to polyethylene-
on-metal implants. The metal-on-metal implants do not
form particulate as fast or in as great a quantity as
polyethylene. The metal-on-metal implants experience
an accelerated wear rate that eventually ceases as com-
pared to polyethylene-on-metal implants that continu-
ously wear. The results from [26] shows a comparison of
polyethylene-on-metal and metal-on-metal roughness
and wear values are shown in Table 13 [26].
8. Summary
The wear mechanisms in biomedical implants par-
ticularly hip joints are found to be a function of the
following variables: type of materials used, contact
stresses, lubricants and clearance, surface hardness and
roughness, type of articulation due to motion, number
of cycles, solution particle count and distribution, and
oxidative wear. Titanium alloys and stainless steels re-
sult in increased wear rates as compared to ceramics and
cobalt chromium alloys. Stainless steels paired with
polyethylene produce higher wear rates than cobalt
chromium on polyethylene, and ceramic (Alumina) on
polyethylene produced the lowest rates of the materials.
The dierent types of kinematic contact stresses
produced dierent wear rates. Rolling contact stresses
produced higher wear rates compared to gliding, and
sliding. Higher contact stresses result in lower coe-
cients of friction and therefore decreasing wear rates.
The type of articulation due to motion has a direct eect
on wear rates. A higher wear rate occurs from concen-
trated particulates in an articulating zone than dispersed
particulates.
Table 13
Wear of metal-on-metal and metal-on-polyethylene prosthetic systems
ID No. Simulator Implants No. R
2
W (mg/Mc) 95% CL
W1 Wear stations Metasul heads 6 0.443 0.7 27
W2 Wear stations Metasul cups 3 0.038 0.91 48
W3 Wear stations Metasul CoCr liners 3 0.109 0.29 100
W4 Wear stations PE cup (CoCR heads) 3 0.962 10.32 7
W5 Wear stations CoCR heads (PE cups) 2 0.409 0.24 53
S1 Soak stations Metasul PE sleeves 3 0.449 0.75 39
S2 Soak stations Metasul cup (CoCR+PE) 3 0.69 2.04 20
S3 Soak stations HB1 CoCR control head 1 0.121 0.03 na
S4 Soak stations PE cups 6 0.683 0.64 16
Table 12
Wear of CoCrMo hip implants
Test No. Run-in wear at
1 10
6
cycles
(mm
3
)
Total volumet-
ric wear at
3 10
6
cycles
(mm
3
)
Steady state
wear rate for
13 10
6
cycles (mm
3
/
million cycles)
1
a
0.27 0.46 0.075
2
a
0.68 0.81 0.057
3 0.58 0.96 0.112
4 0.77 1.02 0.08
5 0.81 1.13 0.11
6
a
0.81 1.45 0.214
7 1.9 2.56 0.18
8
a
0.24 0.52 0.079
Mean SD 0.76 0.51 1.11 0.67 0.11 0.055
9 0.16 0.34 0.07
10 0.22 0.46 0.089
11 0.38 0.62 0.086
12 0.61 0.74 0.054
13 0.02 0.15 0.047
14 0.06 0.23 0.055
MeanSD 0.24 0.22 0.42 0.23 0.067 0.018
15 0.04 0.37 0.153
16 0.1 0.47 0.126
17 0.28 0.4 0.038
18 0.24 0.38 0.038
19 0.28 0.45 0.045
20 0.03 0.16 0.034
21 0.25 0.4 0.039
22 0.42 0.54 0.033
MeanSD 0.21 0.14 0.40 0.11 0.063 0.048
Note. SD standard deviation.
a
Implants tested without ethylenediaminetetraacetic acid additive.
392 A. Buford, T. Goswami / Materials and Design 25 (2004) 385393
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