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Acta Biomater. 2012 Jul;8(7):2434-41. doi: 10.1016/j.actbio.2012.03.029. Epub 2012 Mar 23.

What's next? Alternative materials for articulation in total joint replacement.

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Laboratory of Biomechanics and Implant Research, Department of Orthopedics, Trauma surgery and Paraplegiology, Heidelberg University Hospital, Germany.


The use of an artificial joint is always related to a certain amount of wear. Its biological effects, e.g., the osteolysis potential, are a function of the bulk material as well as its debris. Following comprehensive experiences with polyethylene (PE) wear, material science is tracking two ways to minimize the risk of a particle-induced aseptic implant loosening: (i) reduction of the PE debris by a low-wearing articulation partner; and (ii) replacement of the PE by other materials. Therefore, new ceramics (e.g., ZTA, Si(3)N(4)), as well as coatings (e.g., TiN, "diamond-like" carbon) and modifications of a bulk metal (e.g., oxidizes zirconium) or cushion bearings (polyurethane, hydrogels), are currently available for total joint replacements or have been used for pre-clinical testing. This review gives a brief overview and evaluates the potential of those that have recently been published in literature.

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