The Counterface, Surface Smoothness, Tolerances, and Coatings in Total Joint Prostheses

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Abstract
Proper counterface material combinations, surface finish, and tolerances of contact surfaces are important issues in minimizing friction, wear, and corrosion of total joint prostheses. In the current study, the potential of novel amorphous diamond coatings to solve some present problems in total joint prostheses was studied by using tribological tests with a hip joint simulator and pin-on-disk testers. Based on the tests, the wear of amorphous diamond is negligible compared with conventional hip joint materials (10,000 to 1,000,000 times lower). The coefficient of friction of diamond-coated artificial hip joint was 0.03 to 0.06 when tested in saline solution with loads from 200 to 1000 kg for as many as two million cycles. The friction remained stable throughout the tests. Methylmethacrylate (bone cement) is a typical source of third body wear particles in cemented total hip replacements. The wear tests showed that bone cement (containing hard ceramic particles of barium sulfate or zirconia) severely scratched cobalt chromium molybdenum alloy samples. These scratches enhance the wear of softer counterpart materials, such as polyethylene or bone cement, whereas diamond-coated surfaces remained undamaged. High quality amorphous diamond coatings offer superior stability (minimal wear debris release in surrounding tissues) and good biomechanical performance.