Hemiarthroplasty in young patients.


Journal

The bone & joint journal
ISSN: 2049-4408
Titre abrégé: Bone Joint J
Pays: England
ID NLM: 101599229

Informations de publication

Date de publication:
01 Nov 2024
Historique:
medline: 1 11 2024
pubmed: 1 11 2024
entrez: 31 10 2024
Statut: epublish

Résumé

The survival of humeral hemiarthroplasties in patients with relatively intact glenoid cartilage could theoretically be extended by minimizing the associated postoperative glenoid erosion. Ceramic has gained attention as an alternative to metal as a material for hemiarthroplasties because of its superior tribological properties. The aim of this study was to assess the in vitro wear performance of ceramic and metal humeral hemiarthroplasties on natural glenoids. Intact right cadaveric shoulders from donors aged between 50 and 65 years were assigned to a ceramic group (n = 8, four male cadavers) and a metal group (n = 9, four male cadavers). A dedicated shoulder wear simulator was used to simulate daily activity by replicating the relevant joint motion and loading profiles. During testing, the joint was kept lubricated with diluted calf serum at room temperature. Each test of wear was performed for 500,000 cycles at 1.2 Hz. At intervals of 125,000 cycles, micro-CT scans of each glenoid were taken to characterize and quantify glenoid wear by calculating the change in the thickness of its articular cartilage. At the completion of the wear test, the total thickness of the cartilage had significantly decreased in both the ceramic and metal groups, by 27% (p = 0.019) and 29% (p = 0.008), respectively. However, the differences between the two were not significant (p = 0.606) and the patterns of wear in the specimens were unpredictable. No significant correlation was found between cartilage wear and various factors, including age, sex, the size of the humeral head, joint mismatch, the thickness of the native cartilage, and the surface roughness (all p > 0.05). Although ceramic has better tribological properties than metal, we did not find evidence that its use in hemiarthroplasty of the shoulder in patients with healthy cartilage is a better alternative than conventional metal humeral heads.

Identifiants

pubmed: 39481451
doi: 10.1302/0301-620X.106B11.BJJ-2024-0432.R2
pii: BJJ-2024-0432.R2
doi:

Substances chimiques

Metals 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1273-1283

Informations de copyright

© 2024 Mahmud et al.

Déclaration de conflit d'intérêts

H. Mahmud reports funding from the Brunei UBD Chancellor’s PhD Scholarship, related to this study. D. Wang reports research consulting fees from Imperial College London, related to this study. C. H. Heinrichs and U. N. Hansen report the provision of implants by orthopaedic manufacturer Mathys Ltd Bettlach, related to this study. A. A. Amis and R. Emery report an institutional grant (paid to Imperial College London) from the Wellcome Trust to fund the project to build the shoulder wear simulator, related to this study.

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Auteurs

Hazimah Mahmud (H)

Department of Mechanical Engineering, Imperial College London, London, UK.
Faculty of Integrated Technologies, Universiti Brunei Darussalam, Jalan Tungku Link, Brunei Darussalam.

Dong Wang (D)

Department of Mechanical Engineering, Imperial College London, London, UK.
Department of Engineering, Faculty of Environment, Science and Economy, University of Exeter, Exeter, UK.

Andra Topan-Rat (A)

Department of Bioengineering, Sir Michael Uren Hub, Imperial College London, London, UK.

Anthony M J Bull (AMJ)

Department of Bioengineering, Sir Michael Uren Hub, Imperial College London, London, UK.

Christian H Heinrichs (CH)

Mathys Ltd Bettlach, Bettlach, Switzerland.

Peter Reilly (P)

Department of Bioengineering, Sir Michael Uren Hub, Imperial College London, London, UK.

Roger Emery (R)

The Hamlyn Centre, Imperial College London, London, UK.

Andrew A Amis (AA)

Department of Mechanical Engineering, Imperial College London, London, UK.

Ulrich N Hansen (UN)

Department of Mechanical Engineering, Imperial College London, London, UK.

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