Biomaterial and design concepts to minimize wear in total joint arthroplasties

The evolution of high technology-based total joint arthroplasty (TJA) materials and designs has resulted in systems that provide significant advantages related to surgical procedures, functional mechanics, and short-term and long-term rehabilitation. The research and development community has been addressing key issues associated with attachment-to-tissues for force transfer and wear and debris from articulating surfaces. To minimize wear, multiple material and design technologies have been applied, with recent emphasis on surface and bulk modifications of alloys and polymers plus the reconsideration of ceramic and metallic articulations. This article provides an overview of the biomaterial considerations for articulating surfaces of existing TJA systems, efforts to control wear phenomena, and implications on the clinical aspects of long-term function.