Silicon nitride for total hip replacements

Pettersson, M. 2015. Silicon nitride for total hip replacements. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology 1242. 53 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-554-9211-3. For more than 50 years total hip replacements have been a common and successful procedure to increase patient mobility and quality of life. The 10-year implant survival rate is 97.8%. However, for longer implantation times there are limitations linked to the negative biological response to wear and corrosion products from the currently used biomaterials. In this thesis silicon nitride (SiNx) coatings were evaluated for use in total hip replacements, on the articulating bearing surface and modular taper connections. Homogeneous, dense SiNx coatings were deposited using reactive high power impulse magnetron sputtering (HiPIMS) up to a thickness of 8 μm. The N/Si atomic ratios ranged from 0.3 to 1.1 and the coatings showed a low surface roughness. The wear rate of a SiNx coated cobalt chromium molybdenum alloy (CoCrMo) was similar to that of bulk Si3N4, and less than one 46 of uncoated CoCrMo, an alloy that is commonly used in joint replacements. Wear debris generated from SiNx coatings was round in shape, with a mean size of 40 nm, and ranged between 10 and 500 nm. Model particles, similar in size and shape as the wear debris, were soluble in simulated body fluid. The dissolution rate was higher than the expected rate of debris generation. Along with the size of the debris, which is not in the critical range for macrophage activation, this dissolution may limit negative biological reactions. The SiNx coatings also dissolved in simulated body fluid. The coating with the highest N/Si ratio exhibited the lowest dissolution rate, of 0.2 to 0.4 nm/ day, while CoCrMo under the same condition dissolved at a rate of 0.7 to 1.2 nm/day. SiNxcoated CoCrMo exhibited a reduced release of Co, Cr and Mo ions into the solution by two orders of magnitude, compared to uncoated CoCrMo. Si3N4 evaluated under micro-displacement in a corrosive environment, replicating the modular taper, showed a lower corrosion current compared to common biomedical alloys. SiNx coatings may also act beneficially to reduce issues associated with this type of contact. SiNx coatings have shown several properties in a laboratory environment that are hypothesised to increase the longevity of joint replacements. The promising results encourage further evaluation closer to the clinical application of total hip replacements, in particular in the articulating bearing surface and in modular tapers.