Generation of fretting wear debris at the stem-cement interface in total hip replacement

Fretting wear debris generated at the stem–cement interface has nowadays been considered to play an important role in the overall failure of cemented total hip replacement (THR). Those wear debris within a certain size range would transport along bone cement deficiencies to bone tissue, resulting in a significant bone resorption and subsequent aseptic loosening of the femoral component, which is regarded as the primary reason for revision of cemented THR. In order to study the influence of the time period of in vivo service of the prosthesis on generation of fretting wear debris, we performed two in vitro wear simulations using identical femoral stem and bone cement, but applying different loading cycles. By conducting a detailed investigation of the bone cement surface with the use of optical microscope, scanning electron microscope (SEM) associated with energy dispersive X-ray (EDX) analysis, we came to a conclusion that for the specific bone cement studied, sufficient loading cycles were required to dislodge the metallic debris from the femoral stem surface, which indicated that generation of fretting wear debris was indeed influenced by the time period of in vivo service of the prosthesis.