A critical component is the bearing surface, and good wear performance is now seen to be necessary for the long-term survivorship and overall performance of the joint. The modern surgeon is fortunate in having many more therapeutic options at his disposal.
Currently bearing surfaces for hip joints fall into two broad categories. Firstly, the so-called ‘hard-on-soft’ combinations in which hard materials such as metal (sometimes coated) or ceramics articulate against polyethylene. Secondly, the so-called hard-on-hard bearing surfaces in which the same hard components articulate against themselves. Improvement in material technology has enabled the development of large diameter articulations, which are not only more resistant to dislocation but have much lower wear when applied to hard-on-hard bearings.
The aim of this paper is to review
- The limitation of UHMWPE
- Lubrication theory
- Current generation of bearings
- Future solutions
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