Wear of the polyethylene liner-metallic shell interface in modular acetabular components. An in vitro analysis

The purpose of this study was to determine the effect of compression cycles and wear patterns on the polyethylene liner-metallic shell interface in modular acetabular components. Articular frictional torque was also measured. Modular acetabular components from five manufacturers were tested. The polyethylene liners were sputter coated with gold on the convex surface to enhance the visualization of wear and deformation patterns. Each component was cycled for 10 million cycles in a hydraulic fatigue testing machine. Frictional torque was measured prior to the start of the cyclic loading and in increments of 2 million cycles. Frictional torque was significantly lower in the design with an enhanced polyethylene liner. Abrasion of the gold from the convex surface of polyethylene liners varied from 2 to 23% between designs. Extrusion of the polyethylene into the screw holes in the metallic shells was universal. Three modes of damage (burnishing, punch-out, and gouging) were identified on the convex surface of the polyethylene liner. Abrasion of the gold from the convex surface of the polyethylene varied greatly between designs. This is indicative of relative motion between the polyethylene liner and the metallic shell. This motion must be minimized to limit the generation of wear debris from the convex surface of the polyethylene. Several aspects of modular acetabular component design could be implemented to potentially reduce wear, including limiting the number of holes available for screw placement, smoothing out the edges of the screw holes to avoid punch-out, and avoiding supplemental fixation of the liner unless it is essential to prevent motion between the liner and the metallic shell.