Today's News

Thursday, February 14, 2002

Alternative bearing surface solutions reexamined

Patient profiles have changed substantially over the last three decades of arthroplasty use, resulting in greater service life demand for ultra high molecular weight polyethylene (UHMWPE) hip components. Material failure, often leading to osteolytic response, has been increasingly associated with younger, more active patients. In this context, the original Charnley low friction solution has become a problem leading to examination and reexamination of alternative bearing surfaces.

Scientific exhibit 12, sponsored by the AAOS Committee on Biomedical Engineering and Committee on Hip and Knee Arthritis, presents state-of-the-art applications of these surfaces. It gives clinical and laboratory evidences for alternative bearing surface solutions and addresses efficacy and concerns of each bearing couple.

Recently, a class of highly cross-linked polymers has demonstrated a significant reduction in wear particle generation in laboratory simulators. They have been cleared for clinical use in the hip through the regulatory process, but to-date have no clinical experience to demonstrate their in vivo effectiveness.

A number of metal-metal articulations have received 510K clearance and are also available for clinical use.

Ceramic-ceramic couples are now anticipated to enter the American marketplace following their first FDA Advisory Panel recommendation for approval.

Researchers are A. Seth Green-wald, DPhil (Oxon), Cleveland, Ohio; Jonathan P. Garino, MD, Philadelphia, Penn. (Research or institutional support from Wright Medical Technology and consultant or employee of Smith & Nephew); David C. Ayers, MD, Syracuse, NY; Joshua J. Jacobs, MD, Chicago, Ill. (Research or institutional support from Merck, Wright Medical Technology, Zimmer, Inc. and consultant or employee of Zimmer, Inc.); and Anastasia K. Skipor, MS, Chicago, Ill. (Research or institutional support from Wright Medical Technology).

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Last modified 15/February/2002