Fabrication and testing of silicon nitride bearings in total hip arthroplasty: winner of the 2007 "HAP" PAUL Award.

Total hip arthroplasty (THA) bearings were fabricated from silicon nitride (Si(3)N(4)) powder. Mechanical testing showed that Si(3)N(4) had improved fracture toughness and fracture strength over modern alumina (Al(2)O(3)) ceramic. When tested with Si(3)N(4) cups in a hip simulator, both cobalt-chromium (CoCr) and Si(3)N(4) femoral heads produced low wear rates that were comparable to Al(2)O(3)-Al(2)O(3) bearings in THA. This study offers experimental support for a novel metal-ceramic THA bearing couple that combines the reliability of CoCr femoral heads with the wear advantages of ceramic surfaces.

Testing of silicon nitride ceramic bearings for total hip arthroplasty.

Modern ceramic bearings used in total hip arthroplasty (THA) consist of a femoral head (ball) articulating inside a hemispherical acetabular cup (socket); the ball and socket are made of alumina (Al(2)O(3)) and Al(2)O(3)-based composite materials. In the present study, total hip bearings were made from a different ceramic material, silicon nitride (Si(3)N(4)), by sintering and hot isostatic pressing of powders. The resulting material had improved mechanical properties over modern Al(2)O(3) THA bearings, with a flexural strength of 920 +/- 70 MPa, a Weibull modulus of 19, and a fracture toughness of 10 +/- 1 MPa m(1/2). Unlike zirconia-based ceramics that have also been used in THA, accelerated aging of Si(3)N(4) did not adversely affect the flexural strength. In simulated wear tests, Si(3)N(4) acetabular cups produced low-volumetric wear whether articulating against Si(3)N(4) or cobalt-chromium (CoCr) femoral heads. The results of this investigation suggest that Si(3)N(4) may allow improved THA bearings that combine the reliability of metal femoral heads with the low wear advantages of ceramic materials.