Total Hip Arthroplasty

BME 181
By: Erik Walder
What is total hip arthroplasty?
• Total Hip Replacement
• Bone is sheared away and an
artificial hip is implanted
• Osteoarthritis, trauma, and
overuse make people
candidates
How does the implant work?
• The ‘stem’ is drilled into
the femur
• The ‘ball’, also known as
the bearing, acts as the
femoral head
• The ‘liner’ acts as the
acetabulum
Cemented vs. Un-cemented Implants
• Cemented
▫ Liner is permanently attached
to the pelvis
• Un-cemented
▫ Liner is only temporarily
attached
▫ Liner consists of porous
material compatible for bone
growth
▫ Bone grows and secures liner
in place
Metal Ball with Polyethylene Liner
Wear Rate: 0.1 mm/yr Pros/Cons
• Most common implant
• Metal is usually made from
cobalt chrome molybdenum
alloy
• Pieces from wear and tear can
cause inflammation/bone loss
Ceramic Ball with Polyethylene Liner
Wear Rate: 0.05 mm/yr Pros/Cons
• Harder than metal
• Don’t scratch very much
• Less wear means less
inflammation/bone loss
• More expensive
• In the past ceramics were
brittle and cracked
▫ Not usual anymore
Metal ball with Metal Liner
Wear Rate: 0.01 mm/yr Pros/Cons
• cobalt chromium alloy
• Allows for a larger ball
▫ More like natural joint
▫ Increased range of motion
• Fairly low wear rate
• Particles from wearing may
cause adverse health effects
• May perform better over long
term
• More sizing options
Ceramic Ball with Ceramic Liner
Wear Rate: 0.0001 mm/yr Pros/Cons
• Incredibly low wear rate
• Very hard and strong
• No particles from wear are
dispersed through the body
▫ No inflammation
▫ No bone loss
• A wide range of sizing to meet
patient specific needs
Picture References
• http://www.mayoclinic.com/health/medical/IM
00342
• http://www.bonesmart.org/hip_replacement.ph
p?gclid=CNHJ-K_9jqECFd1n5QodrVJ_Mw
• http://www.mayoclinic.com/health/medical/IM
00341
• http://www.yalemedicalgroup.org/stw/images/1
25680.jpg