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Total Hip Arthroplasty - A Future Without Metal-On-Metal Bearings

Posted by Stephen K. Sugarman

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One of the most important issues surrounding Total Hip Arthroplasty (replacement) is the future of bearing surfaces. The bearing surfaces of an artificial hip joint ideally have sound wear characteristics and durability, are bio-inert and relatively easy to implant. Hip recalls, including the DePuy ASR and Stryker Rejuvenate and ABG II, represent a loss in confidence and movement away from metal-on-metal articulating surfaces. Growing reports of cobalt and chromium toxicity, device failure and revision surgery in patients implanted with metal bearings have forced surgeons and manufacturers to look to new solutions for the composition of bearing surfaces.

Future bearing surfaces will including improved polyethylene and ceramic components. Recent short-term studies have evaluated the efficacy of Vitamin E stabilized polyethylene. By adding the antioxidant Vitamin E to polyethylene under specific controlled conditions, researchers noted that the material exhibited low wear and high strength characteristics compared to polyethylene bearing surfaces on the market. Though these short-term studies are encouraging, long-term analysis is still required to understand the longevity of the material. Research is also underway to improve upon the strength of existing fourth-generation ceramics which have been engineered to inhibit cracking. Alternative new materials are also being considered for hip surfaces. Diamond-like carbon film may be a viable solution. It is known for superior tribological and mechanical properties, as well as inertness and compatibility with biomedical devices. Carbon-based composite materials also offer a potential low wear, high durability articulating surfaces. Whatever the products of the future will be, the search is underway for alternatives to metal-on-metal bearings that permit decreased joint friction and wear rates but increased strength.

SUGARMAN has a team of lawyers dedicated to handling defective and recalled hip system claims. If you have any questions regarding DePuy or Stryker hips, please fill out a Contact Form, call us at (617) 542-1000 or e-mail info@sugarman.com.