Problems with wear in artificial orthopaedic joint replacements: a review

This paper reviews the development of artificial hip and knee replacements to show how our choice and combination of the materials used, including metal on polymer, metal on metal, metal on ceramic, ceramic on ceramic has led to progressive improvements in their performance and durability. Special attention is paid to describing the tribological conditions within these joints in order to explain the causes and mechanisms of wear and to show how these affect the nature size and quantity of any wear debris produced. The role that this wear debris plays in causing failure of the implant by osteolysis and damage to surrounding tissues is outlined. The paper concludes by reviewing developments undertaken to combat wear and to minimise the harmful effects of wear debris.