Wear of large ceramic-on-ceramic bearings for total hip arthroplasty and the mechanical and tribological properties of silicon nitrides

Abstract

Dislocation is one of the major revision factors in total hip arthroplasty (THA) with a rate of 1-6 % for primary surgeries [1-4] and up to over 20 % for revision surgeries [5]. Using larger bearing couples has shown an increase of the range of motion and increased stability [6] and at the same time a reduction of the dislocation risk due to a less likelihood of component-on-component impingement [7, 8]. A large number of clinical retrospective studies have shown good early, midterm, and long-term outcomes of larger diameter THAs in terms of dislocation rates [8-11] compared to smaller diameter components.