Assessment of acetabular cup wear with computed tomography and influence of surface roughness on wear of materials for hip prostheses

Abstract: Over one million hip prostheses are implanted in patients worldwide each year and the need is increasing as the patient group of younger and more active patients is increasing. Many parameters affect the longevity of the implant, where aseptic loosening caused by wear debris is the most common reason for revision. To be able to monitor wear in vivo and also to predict the longevity of new materials for hip prostheses are therefore important issues in this interdisciplinary research area. This thesis comprise a true non-invasive 3D method for determination of acetabular cup wear using Computed Tomography (CT) intended for clinical routine use in order to plan for a revision. It also comprises investigations of the influence of surface roughness and sterilization method in wear testing of materials for hip prostheses. Mainly wear of ultra high molecular weight polyethylene (UHMWPE) was investigated since it is the most common soft bearing in hip prostheses. The 3D-CT method was found to be easy to use and showed an accuracy and repeatability at a clinical relevant level for acetabular cup wear. It should lend itself well to semi-automation. The influence of surface roughness was investigated with both a multidirectional pin-on-disk machine and with a hip simulator. A new low friction coating, Micronite, was also evaluated with the pin-on-disk machine. This coating showed potential for use in artificial joints, but further investigations are needed. In the hip simulator test, it was found that not only a rougher counter surface increased wear, but also sterilization by γ-irradiation increased wear of UHMWPE cups.