Sunday, September 4, 2011

New insights into wear and biological effects of metal-on-metal bearings.

Tribology is a new topic for this blog.  What is Tribology?  Tribology is the science and engineering of interacting surfaces in relative motion. It includes the study and application of the principles of friction, lubrication and wear. Tribology is a branch of mechanical engineering.  Interesting because it highlights the uncertainty that is caused by the metal wear debris and what the exact mechanisms are that cause the inflammation around the hip.
Another topic of discussion in this paper is theT lymphocyte-mediated hypersensitivity response from the wear rate.  Cell-mediated immunity is directed primarily at microbes that survive in phagocytes and microbes that infect non-phagocytic cells. It is most effective in removing virus-infected cells, but also participates in defending against fungi, protozoans, cancers, and intracellular bacteria.
I continue to be interested in  the potential in the  metals in inhibiting the defences against cancer in the cells affected.
J Bone Joint Surg Am. 2011 May;93 Suppl 2:76-83.  Catelas I, Wimmer MA.


Department of Mechanical Engineering, University of Ottawa, 161 Louis Pasteur, Ottawa, ON K1N 6N5, Canada.



Despite the renewed interest in metal-on-metal implants in the past two decades, the underlying wear mechanisms and biological effects are still not fully understood.


This paper first reviews the tribology of metal-on-metal bearings, bringing new insights into the interaction of wear and corrosion, and putting the characteristics and the potential origin of wear particles in perspective with the proposed wear mechanisms. It then summarizes the current knowledge on the biological effects of particles and metal ions in relation to these wear mechanisms.


Tribochemical reactions play an important role in the wear of metal-on-metal joints. The generated tribomaterial, which progressively forms by mechanical mixing of the uppermost nanocrystalline zone of the metal surface with proteins from the synovial fluid, governs the wear rate and influences the corrosive behavior of the bearing. Nanometer-sized wear particles may initially originate from the passivation layer covering the implant surface and then detach from this tribolayer. The inflammatory response observed surrounding metal-on-metal implants appears to be lower than that around metal-on-polyethylene implants. However, metallic byproducts, which can complex with proteins, may lead to a T lymphocyte-mediated hypersensitivity response.


The tribolayer appears to have beneficial effects on the wear rate. Much information has been gained on wear particle characteristics, but the exact mechanisms of particle detachment remain to be further elucidated. Excessive wear along with a hypersensitivity response may be at the origin of the early adverse tissue reactions that have been recently reported in some patients with metal-on-metal implants

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