Surface Roughness of Ceramic Femoral Heads After in Vivo Transfer of Metal

Publisher Website
Google Scholar
Abstract
Background: A dark metallic-appearing smear, resembling a lead pencil mark, may be seen on a ceramic femoral head component at revision total hip arthroplasty. The purpose of this study was to investigate the hypothesis that such a mark on a retrieved ceramic femoral head is associated with increased surface roughness of the head and increased polyethylene liner wear in total hip replacement. Methods: Fifteen ceramic prosthetic femoral heads retrieved from fifteen patients at revision arthroplasty were examined in this study. Thirteen heads had been in vivo for an average of 10.8 years (range, 7.8 to 14.2 years). The remaining two heads had been in vivo for less than one month. The surface roughness characteristics of the explanted ceramic heads, the linear wear of the polyethylene liner, and the patient activity levels after the primary replacement and before the revision were determined. Results: Four of the thirteen ceramic heads that had been in vivo for ≥7.8 years had severe smears (>6% of the surface area), and the remaining nine heads had slight smears (Conclusions: The results of this study confirm the hypothesis that a visual dark metallic-appearing smear on a ceramic femoral head correlates with increased surface roughness of the head and increased polyethylene wear. These findings imply that contact of a ceramic femoral head with a metallic material, such as may occur with femoral head reduction or dislocation of a total hip replacement, is best avoided to prevent this metallic smear phenomenon.