Sage Journals: Discover world-class research

Abstract

BACKGROUND:

Accelerated hydrothermal aging has long been one of the most widely accepted quality control tests for simulating low-temperature degradation (LTD) in zirconia-containing implants used in total hip arthroplasty (THA). However, it is still unclear how much consistency there is between the experimental prediction from the internationally-standardized tests and the actual measurements from surgically-removed implants after a long period of implantation. This question is fundamentally related to a lack of understanding of mechanical/tribological contribution to the in-vivo LTD kinetics.

OBJECTIVE:

The main purpose of this study is to validate the clinical relevance of standardized accelerated aging by comparing artificially-aged and in-vivo used prostheses, and to clarify the long-term effects of in-vivo mechanics/tribology on the LTD progression upon service in the body environment.

METHODS:

Surface magnitudes of phase transformation and residual stress in zirconia femoral head retrievals (13.1–18.4 yrs) were evaluated by using confocal Raman microspectroscopy.

RESULTS:

The long-term aging behavior in unworn head surface was in agreement with the experimental prediction estimated as 1 h aging at 134 °C = 4 years in-vivo. However, the current aging protocols based on ASTM and ISO criteria were not accurately predictive for the worn surfaces, and the tribologically-induced phase transformation and tensile stress were up to 6.5-times and 3.3-times higher than the environmentally-induced ones.

CONCLUSION:

Our study suggests that wear/scratching, frictional heating, tribochemical reactions, and metal transfer may become far more intense triggers to phase transformation than the mere exposure to body fluid.

Keywords

Aging kinetics zirconia femoral head phase transformation residual stresses

Get full access to this article

View all access options for this article.

References

Clarke

I.C.

, Metastable nature of zirconia femoral heads from a 20-year perspective of clinical and simulator wear studies, Semin. Arthroplast. 17 (2006), 165–178.

Masonis

J.L.

Bourne

R.B.

Ries

M.D.

McCalden

R.W.

Salehi

and Kelman

D.C.

, Zirconia femoral head fractures: A clinical and retrieval analysis, J. Arthroplast. 19 (2004), 898–905.

Hummer III

C.D.

Rothman

R.H.

and Hozack

W.J.

, Catastrophic failure of modular zirconia-ceramic femoral head components after total hip arthroplasty, J. Arthroplast. 10 (1995), 848–850.

Liang

Kawanabe

Ise

Iida

and Nakamura

, Polyethylene wear against alumina and zirconia heads in cemented total hip arthroplasty, J. Arthroplast. 22 (2007), 251–257.

Fernandez-Fairen

Blanco

Murcia

Sevilla

and Gil

F.J.

, Aging of retrieved zirconia femoral heads, Clin. Orthop. Relat. Res. 462 (2007), 122–129.

Yoshitomi

Shikata

Ito

Nakayama

and Nakamura

, Manufacturers affect clinical results of THA with zirconia heads: A systematic review, Clin. Orthop. Relat. Res. 467 (2009), 2349–2355.

Chevalier

, What future for zirconia as a biomaterial? Biomater. 27 (2006), 535–543.

Chevalier

Gremillard

and Deville

, Low-temperature degradation of zirconia and implications for biomedical implants, Annu. Rev. Mater. Res. 37 (2007), 1–32.

Pezzotti

Saito

Takahashi

Fukatsu

and Sugano

, Surface topology of advanced alumina/zirconia composite femora head as compared with commercial femoral heads made of monolithic zirconia, J. Am. Ceram. Soc. 94 (2011), 945–950.

10.

Arita

Takahashi

Pezzotti

Shishido

Masaoka

Sano

and Yamamoto

, Environmental stability and residual stresses in zirconia femoral head for total hip arthroplasty: In vitro aging versus retrieval studies, Biomed Res Int. 2015 (2015), 638502.

11.

Clarke

I.C.

Manaka

Green

D.D.

Williams

Pezzotti

Kim

Y.H.

Ries

Sugano

Sedel

Delauney

Nissan

B.B.

Donaldson

and Gustafson

G.A.

, J. Bone. Jt. Surg. Am. 85 (2003), 73–84.

12.

Katagiri

Ishida

Ishitani

and Masaki

, Direct determination by a Raman microprobe of transformation zone size in Y₂O₃-containing tetragonal ZrO₂ polycrystals, in: Science and Technology of Zirconia III, S. Somiya, N. Yamamoto and H. Yanagida (eds), Advances in Ceramics, Vol. 24, Am. Ceram. Soc., Columbus, 1988, pp. 537--544.

13.

Pezzotti

and Porporati

A.A.

, Raman spectroscopic analysis of phase-transformation and stress patterns in zirconia hip joints, J. Biomed. Opt. 9 (2004), 372–384.

14.

Pezzotti

Munisso

M.C.

Porporati

A.A.

and Lessnau

, On the role of oxygen vacancies and lattice strain in the tetragonal to monoclinic transformation in alumina/zirconia composites and improved environmental stability, Biomater 31 (2010), 6901–6908.

15.

Takahashi

Zhu

Sugano

and Pezzotti

, On the role of oxygen vacancies, aliovalent ions and lattice strain in the in vivo wear behavior of alumina hip joints, J. Mech. Behav. Biomed. Mater. 4 (2011), 993–1003.

16.

Fukatsu

Leto

Zhu

Sugano

and Pezzotti

, Kinetics and the role of off-stoichiometry in the environmentally driven phase transformation of commercially available zirconia femoral heads, Acta Biomater. 8 (2012), 1639–1647.

17.

and McKellop

, Frictional heating of bearing materials tested in a hip joint wear simulator, Proc. Inst. Mech. Eng. H. 211 (1997), 101–108.

18.

Brown

S.S.

Green

D.D.

Pezzotti

Donaldson

T.K.

and Clarke

I.C.

, Possible triggers for phase transformation in zirconia hip balls, J. Biomed. Mater. Res. B. Appl. Biomater. 85 (2008), 444–452.

19.

Essner

and Wang

, Tribological assessment of UHMWPE in the hip, in: UHMWPE Biomaterials Handbook, Second Edition: Ultra-High Molecular Weight Polyethylene in Total Joint Replacement and Medical Devices Kurtz

S.M.

(ed.), Academic Press, Burlington, (2009), pp. 369–379.

20.

Perrichon

Reynard

Gremillard

Chevalier

Farizon

and Geringer

, A testing protocol combining shocks, hydrothermal ageing and friction, applied to Zirconia Toughened Alumina (ZTA) hip implants, J. Mech. Behav. Biomed. Mater. 65 (2017), 600–608.

21.

Williams

Butterfield

Stewart

Ingham

Stone

and Fisher

, Wear and deformation of ceramic-on-polyethylene total hip replacements with joint laxity and swing phase microseparation, Proc. Inst. Mech. Eng. H. 217 (2003), 147–153.

22.

Boffelli

Doimo

Marin

Puppulin

Zhu

Sugano

Clarke

I.C.

and Pezzotti

, Chemically driven tetragonal-to-monoclinic transformation in retrieved ZTA femoral heads from dual mobility hip implants, J. Mech. Behav. Biomed. Mater. 56 (2016), 195–204.

23.

Bal

B.S.

Zhu

Zanocco

Marin

Sugano

McEntire

B.J.

and Pezzotti

, Reconciling in vivo and in vitro kinetics of the polymorphic transformation in zirconia-toughened alumina for hip joints: I. Phenomenology, Mater. Sci. Eng. C Mater. Biol. Appl. 72 (2017), 252–258.

24.

Pezzotti

Zhu

Zanocco

Marin

Sugano

McEntire

B.J.

and Bal

B.S.

, Reconciling in vivo and in vitro kinetics of the polymorphic transformation in zirconia-toughened alumina for hip joints: II. Theory, Mater. Sci. Eng. C Mater. Biol. Appl. 71 (2017), 446–451.

25.

Pezzotti

Bal

B.S.

Zanocco

Marin

Sugano

McEntire

B.J.

and Zhu

, Reconciling in vivo and in vitro kinetics of the polymorphic transformation in zirconia-toughened alumina for hip joints: III. Molecular scale mechanisms, Mater. Sci. Eng. C Mater. Biol. Appl. 71 (2017), 552–557.

26.

Gremillard

Martin

Zych

Crosnier

Chevalier

Charbouillot

Sainsot

Espinouse

and Aurelle

J.L.

, Combining ageing and wear to assess the durability of zirconia-based ceramic heads for total hip arthroplasty, Acta Biomater. 9 (2013), 7545–7555.

Does artificial aging correctly predict the long-term in-vivo degradation behavior in zirconia hip prostheses?

Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Keywords

Get full access to this article

References