Friction moments of large metal-on-metal hip joint bearings and other modern designs

Modern hip joint replacements are designed to minimise wear problems. The most popular metal-on-polyethylene components are being updated by harder metal and ceramic combinations. However, this has also been shown to influence the friction moments, which could overload the interface between the implant and the body. In this study custom test apparatus was used to measure the joint moments in various modern bearings under simulated physiological joint conditions. The largest moments in serum were measured for large diameter metal–metal bearings (<8 Nm for standard bearings), followed by metal–polyethylene, and the lowest moments were for small diameter ceramic–ceramic and ceramic–metal combinations. Water as a lubricant was found to double the moments in comparison with serum. In metal–metal bearings moments were reduced by increasing loading frequency. Swing phase load and a rest period between load cycles had little effect. The moment magnitudes are within the turn-out capacity measured for press-fit cups and might become critical with higher joint loads.