Abstract Background Metal release of cobalt chromium (CoCr-) knee implants can lead to toxic reactions of the periprosthetic tissue, especially for patients having hypersensitivity against the metallic ingredients. Therefore, ceramic coatings, such as titanium niobium nitride (TiNbN), are used to inhibit the metal release of the CoCr-alloy. The aim of the present study was to determine the metal release and the polyethylene (PE-) wear of TiNbN-coated in comparison to conventional CoCr-knee implants. Methods Uncoated CoCr- and TiNbN-coated knee implants of identical design (Triathlon®, Stryker Corporation, Kalamazoo, USA) were tested according to ISO 14243-1:2009. Wear analysis of the PE-inserts and a determination of the metal release were carried out. Results The coated knee implants led to a higher PE-wear rate (1.75 ± 0.47 mg/106 cycles) than the uncoated knee implants (0.94 ± 0.18 mg/106 cycles), but no significant difference was found (p = .081). The metal release analysis showed a more than tenfold decrease for cobalt and a more than fivefold decrease for chromium, when using a TiNbN-coating. Conclusion Due to the reduced metal release of cobalt and chromium, TiNbN-coated knee implants can be an alternative to the commonly used CoCr-alloy for patients with hypersensitivity against the metal components.

中文翻译：

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TiNbN 涂层膝关节植入物的聚乙烯磨损和金属释放

摘要 背景钴铬 (CoCr-) 膝关节植入物的金属释放会导致假体周围组织的毒性反应，尤其是对金属成分过敏的患者。因此，陶瓷涂层，例如钛铌氮化物 (TiNbN)，用于抑制 CoCr 合金的金属释放。本研究的目的是确定与传统 CoCr 膝关节植入物相比，TiNbN 涂层的金属释放和聚乙烯 (PE-) 磨损。方法 根据 ISO 14243-1:2009 测试相同设计的无涂层 CoCr 和 TiNbN 涂层膝关节植入物（Triathlon®，Stryker Corporation，Kalamazoo，USA）。进行了 PE 嵌件的磨损分析和金属释放的测定。结果涂层膝关节植入物导致更高的 PE 磨损率 (1.75 ± 0. 47 毫克/106 周期）比未涂层膝关节植入物（0.94 ± 0.18 毫克/106 周期），但没有发现显着差异（p = .081）。金属释放分析表明，当使用 TiNbN 涂层时，钴减少了十倍多，铬减少了五倍多。结论 由于钴和铬的金属释放减少，TiNbN 涂层膝关节植入物可以替代常用的 CoCr 合金，用于对金属成分过敏的患者。