Ceramic femoral heads prevent runaway wear for highly crosslinked polyethylene acetabular cups by third-body bone cement particles

Third-body wear due to entrapment of loose bone cement particles has been identified as one of the major factors that are responsible for elevated wear debris generation in total hip replacement. Previous studies have shown that the wear rate of non-crosslinked UHMWPE acetabular cups against metallic femoral heads accelerates significantly with increasing the concentration of cement particles in lubricant whereas the use of ceramic heads prevents such a runaway wear. The present study looks at the effect of third-body bone cement particles on the wear rate of highly crosslinked UHMWPE acetabular cups against both metal and ceramic femoral heads in a hip joint simulator. It is hypothesized that ceramic heads would prevent runaway wear for highly crosslinked polyethylene cups against a heavy concentration of polymethylmethacrylate (PMMA) bone cement particles in lubricant. This hypothesis was indeed verified by the present hip simulator study.