FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2793289670> ?p ?o ?g. }

• W2793289670 endingPage "195" @default.
• W2793289670 startingPage "193" @default.
• W2793289670 abstract "Where Are We Now? Oxidized zirconium components are manufactured by exposing zirconium alloy to heat and oxygen, forming a hardened ceramic layer a few microns deep across its surface. The goal for this material is to provide superior wear resistance without the fracture risk of traditional ceramics used for articular bearings in arthroplasty. Smith & Nephew brought the technology to market under the trade name Oxinium™ (Smith & Nephew, Memphis, TN, USA) in the early 2000s, with the intention to use it in articulations against polyethylene. It is available for femoral heads in THA and femoral components in TKA. Preclinical wear simulator studies confirmed the superiority of oxidized zirconium’s wear resistance over cobalt chromium [3], but this has not necessarily translated to patients. Although in vivo wear measurements with total hip replacements have shown low wear rates, more studies have found no difference compared to cobalt chromium bearings than have shown an improvement with oxidized zirconium [5,6,11]. Results of studies examining retrieved total knee replacements have also been mixed, with some reporting improved wear resistance using oxidized zirconium while others show no difference when compared to cobalt chromium [1,4]. However, these studies have only been reported to a mid-term followup, and due to the well-established wear resistance of highly-crosslinked polyethylene it may be that followup will need to be into the second or even third decade before differences in wear rates become substantial. The study by Carli and colleagues investigates a concern that relates to the thin oxidized layer of oxidized zirconium bearings, which provide its wear resistance. A number of case reports have previously shown examples where this layer, once scratched, results in increased surface roughness that may lead to greater polyethylene wear. In one instance, extensive damage was seen on an oxidized zirconium femoral head and the associated highly-crosslinked polyethylene liner in a patient who was revised just 48 hours after the index surgery due to a leg length discrepancy [8]. It is thought that this scratching damage occurs with reduction and dislocation of the hip joint. Carli and colleagues approached this problem through a thorough study of 42 retrieved oxidized zirconium femoral heads with polyethylene liners, and a further 12 implants tested with a wear simulator. They were able to conclude that severely scratched oxidized zirconium femoral heads (as seen in patients with recurrent dislocations) increase the magnitude of wear on highly-crosslinked polyethylene to levels associated with conventional noncrosslinked polyethylene. Where Do We Need To Go? These findings raise a number of important questions, and the need to address them is growing with current trends in arthroplasty. The use of ceramic femoral heads for total hip procedures has grown substantially during the past few years, as ceramic materials are believed to be wear resistant and they are thought to reduce the risk of trunnionosis [2]. Retrieval studies have demonstrated that fretting and corrosion are indeed reduced, but not necessarily eliminated, with the use of ceramic femoral heads [7]. However, one study found that there was no substantial difference in these values between oxidized zirconium and cobalt chromium heads [10]. Thus, the resistance of oxidized zirconium to trunnionosis has not yet been fully confirmed. If oxidized zirconium is becoming more widely used, and severe scratching of the bearing surface is occurring, this may lead to a greater risk of wear and potentially osteolysis related problems. We need to determine the clinical prevalence of severe scratching in oxidized zirconium femoral heads. These cases also require further investigation to determine if the scratching is solely occurring in patients that have experienced dislocation, or were otherwise normally functioning. For these cases where scratching has occurred, the magnitude of polyethylene wear should be measured to confirm whether the findings of Carli and colleagues are widespread. It needs to be determined whether there is a negligible change in wear, or if wear is accelerated, is it to a clinically meaningful level where there are concerns that osteolysis may be occurring? If scratched oxidized zirconium bearings are found to be a frequent problem, clinicians may want to reconsider the widespread use of devices made from this material. It appears that the use of oxidized zirconium heads can result in good clinical outcomes following total hip arthroplasty [9], and in at least one study, use of oxidized zirconium was associated with a reduction of polyethylene wear [11]. However, we need to determine whether there is a subpopulation of patients in whom the use of oxidized zirconium should be avoided, perhaps patients thought to be at a heightened risk of dislocation? If a patient with an existing oxidized zirconium bearing dislocates his or her hip, should a closed reduction be attempted, or should that patient undergo a femoral head exchange to prevent the potential for accelerated wear due to a scratched bearing? Given the increased use of ceramic femoral heads in THA, these are important questions to ensure implant longevity. We must be careful to not increase the prevalence of an established problem (scratching and accelerated wear) in order to prevent one that may be more theoretical in nature (trunnionosis). How Do We Get There? To address these questions, the first step is to continue ongoing surveillance of oxidized zirconium implants through retrieval studies. Multicenter collaborations may help to increase the available number of implants for analysis. The focus for these studies should be on establishing the consistency in the pattern of any damage, and tying it to patient demographics and reason for revision, especially a history of dislocation. Such retrieval studies should implement the latest analysis methods for three-dimensional mapping of surface deviations due to wear using coordinate measuring, micro-CT, or laser scanning, as seen in the current study, to provide the most-detailed evaluation possible. Centers that perform a high volume of hip arthroplasties using oxidized zirconium bearings should review their experiences, examining implant survivorship and reasons for revision, particularly in patients who have dislocated their THAs. Ideally, wear rates for these hips would also be measured radiographically, using radiostereometric analysis or one of the various measurement tools for conventional radiographs. In particular, wear rates for patients who have dislocated but not been revised should be compared to patients with a well-functioning hip joint. These rates should be similarly compared to those in patients with ceramic and cobalt chromium bearings. Finally, use of oxidized zirconium should be examined in joint registries, to track implant survivorship and reasons for revision across broader patient populations. Integrating findings across these studies will establish the prevalence and clinical importance of the problem of scratching and wear with oxidized zirconium, and identify factors that are associated with it. This will enable surgeons to make better choices regarding whether oxidized zirconium bearings are right for their patients." @default.
• W2793289670 created "2018-03-29" @default.
• W2793289670 creator A5073690011 @default.
• W2793289670 date "2018-01-17" @default.
• W2793289670 modified "2023-09-26" @default.
• W2793289670 title "CORR Insights®: Polyethylene Wear Increases in Liners Articulating With Scratched Oxidized Zirconium Femoral Heads" @default.
• W2793289670 cites W1137251797 @default.
• W2793289670 cites W1191137180 @default.
• W2793289670 cites W1989282472 @default.
• W2793289670 cites W2017556324 @default.
• W2793289670 cites W2037832246 @default.
• W2793289670 cites W2138395185 @default.
• W2793289670 cites W2264064234 @default.
• W2793289670 cites W2270859746 @default.
• W2793289670 cites W2282728513 @default.
• W2793289670 cites W2411757853 @default.
• W2793289670 cites W2618797024 @default.
• W2793289670 doi "https://doi.org/10.1007/s11999.0000000000000122" @default.
• W2793289670 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/6259724" @default.
• W2793289670 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/29389783" @default.
• W2793289670 hasPublicationYear "2018" @default.
• W2793289670 type Work @default.
• W2793289670 sameAs 2793289670 @default.
• W2793289670 citedByCount "0" @default.
• W2793289670 crossrefType "journal-article" @default.
• W2793289670 hasAuthorship W2793289670A5073690011 @default.
• W2793289670 hasBestOaLocation W27932896701 @default.
• W2793289670 hasConcept C127413603 @default.
• W2793289670 hasConcept C159985019 @default.
• W2793289670 hasConcept C191897082 @default.
• W2793289670 hasConcept C192562407 @default.
• W2793289670 hasConcept C199343813 @default.
• W2793289670 hasConcept C2779751980 @default.
• W2793289670 hasConcept C534791751 @default.
• W2793289670 hasConcept C71924100 @default.
• W2793289670 hasConcept C77595967 @default.
• W2793289670 hasConceptScore W2793289670C127413603 @default.
• W2793289670 hasConceptScore W2793289670C159985019 @default.
• W2793289670 hasConceptScore W2793289670C191897082 @default.
• W2793289670 hasConceptScore W2793289670C192562407 @default.
• W2793289670 hasConceptScore W2793289670C199343813 @default.
• W2793289670 hasConceptScore W2793289670C2779751980 @default.
• W2793289670 hasConceptScore W2793289670C534791751 @default.
• W2793289670 hasConceptScore W2793289670C71924100 @default.
• W2793289670 hasConceptScore W2793289670C77595967 @default.
• W2793289670 hasIssue "2" @default.
• W2793289670 hasLocation W27932896701 @default.
• W2793289670 hasLocation W27932896702 @default.
• W2793289670 hasLocation W27932896703 @default.
• W2793289670 hasLocation W27932896704 @default.
• W2793289670 hasLocation W27932896705 @default.
• W2793289670 hasOpenAccess W2793289670 @default.
• W2793289670 hasPrimaryLocation W27932896701 @default.
• W2793289670 hasRelatedWork W1967014301 @default.
• W2793289670 hasRelatedWork W1989282472 @default.
• W2793289670 hasRelatedWork W2025239265 @default.
• W2793289670 hasRelatedWork W2029662668 @default.
• W2793289670 hasRelatedWork W2058942266 @default.
• W2793289670 hasRelatedWork W2073361599 @default.
• W2793289670 hasRelatedWork W2368673993 @default.
• W2793289670 hasRelatedWork W38529307 @default.
• W2793289670 hasRelatedWork W4230514127 @default.
• W2793289670 hasRelatedWork W563794224 @default.
• W2793289670 hasVolume "476" @default.
• W2793289670 isParatext "false" @default.
• W2793289670 isRetracted "false" @default.
• W2793289670 magId "2793289670" @default.
• W2793289670 workType "article" @default.