Reduction of wear in total hip replacement prostheses by amorphous diamond coatings

Wear-debris-induced periprosthetic bone loss and aseptic loosening is regarded as the main long-term problem of total hip replacements (THRs). In this study the amount of wear debris from articulating surfaces of THRs was reduced so as to be close to negligible by the use of high-quality amorphous diamond (AD) coatings deposited by pulsed plasma arc techniques. The wear rates determined in a commercial hip simulator for 15 million walking cycles (corresponding to about 15 years of clinical use) in serum lubrication were even 1,000,000 times lower than the clinical values for conventional THRs (polyethylene-metal or metal-metal pairs). Elimination of wear debris and good biomechanical performance should provide a substantial improvement of the clinical longevity of the THRs.