Title: Low in vitro third-body wear on total hip prostheses induced by calcium sulphate used for local antibiotic therapy

Author: R Heuberger, P Wahl, J Krieg, E Gautier

Address: RMS Foundation, Bischmattstr 12, CH-2544 Bettlach, Switzerland

E-mail: roman.heuberger at rms-foundation.ch

Key Words: Third-body wear, total hip prosthesis, calcium sulphate, gypsum, plaster of Paris, antibiotic carrier, ultra-high-molecular-weight polyethylene, cross-linked polyethylene, vitamin E.

Publication date: October 23rd 2014

Abstract: In case of implant associated infection, implant preservation is associated with high failure rates. Therefore, a removal or exchange of the implant is most often mandatory for treatment success. Alternatively, under certain conditions, local antibiotic delivery can be applied – preserving the implant, using for example calcium sulphate as a resorbable carrier. In this work, third-body wear on total hip prostheses caused by calcium sulphate particles was tested in a hip simulator. Inlays made of ultra-high-molecular-weight polyethylene (UHMWPE) and cross-linked polyethylene (XLPE) against 28 mm CoCrMo heads and 36 mm alumina pairings were tested in triplicate, both with and without calcium sulphate particles in the test liquid.
Neither the alumina articulations nor the CoCrMo heads were affected by the calcium sulphate particles since calcium sulphate is a relatively soft material. The polyethylene inlays showed 39-89 % higher wear during exposure compared to references, but wear returned to normal when no more particles were added. Thus, calcium sulphate might be used as antibiotic carrier even in the presence of total hip prostheses without fearing excessive third-body wear.

Article download: Pages 246-257 (PDF file)
DOI: 10.22203/eCM.v028a17