Oxinium

(1) Background: Unicompartmental knee arthroplasty (UKA) provides a viable alternative to total knee arthroplasty (TKA) in patients with isolated medial osteoarthritis (OA). From 2007 to 2021, 23% of all primary knee arthroplasties in Italy were UKAs. We retrospectively evaluated clinical outcomes and satisfaction in patients implanted with a new oxinium metal-backed fixed-bearing medial unicompartmental prosthesis at a 24-month follow-up. (2) Methods: From December 2020 to December 2021, 145 patients were treated by a single surgeon at a single institution using the hypoallergenic Journey II prosthesis...

Oxidized zirconium (OxiniumTM) prostheses, made up of a metallic alloy of zirconium with a ceramic surface formed by oxidizing the outer layer, were developed as an alternative bearing surface to reduce polyethylene wear and decrease failure of total knee arthroplasty (TKA). We report a unique catastrophic failure of an Oxinium TKA with consequent accelerated wear and severe metallosis. Intraoperatively, we observed extensive wear grooving of the femoral component with exposure of the underlying silver layers and the complete wear of polyethylene on the medial side...

INTRODUCTION: Oxidized Zirconium (OXINIUM™) is a metal alloy with a ceramic surface, utilized to increase the longevity of knee and hip implantations and reduce polyethylene wear. Polyethylene-based spacers are effective in infection control and prosthetic stability. Therefore, understanding the interactions between the polyethylene spacer and metallic counterparts is essential in surgical decision-making. Furthermore, understanding how patients may present when catastrophic failure of these components arises is imperative...

INTRODUCTION: Polyethylene (PE) subluxation is a rare complication after fixed-bearing unicompartmental knee replacement. We present two cases of PE luxation with a rapid onset of metallosis in a unicompartmental knee replacement made of Oxinium, one early presentation 3 months after surgery and the other case 6 years after. CASE REPORT: Case 1: A 84-year-old male underwent a fixed-bearing medial unicompartmental knee replacement in his left knee. Standard surgery was carried out with robotic assistance...

Oxidized zirconium was first introduced in total hip arthroplasty procedures to merge the strengths of metal and ceramic into one prosthetic. The subsequent adoption of oxidized zirconium (oxinium) for total knee arthroplasty is attributed to the theory of causing less wear on the tibial components compared to the alternative, cobalt chromium. However, the superficial layer of the femoral component is occasionally breached, exposing the softer zirconium substrate. Multiple mechanisms leading to zirconium substrate exposure have been explained, including collateral ligament instability and polyethylene wear...

BACKGROUND: Oxidized zirconium (Oxinium), titanium nitride (TiN) or titanium niobium nitride (TiNbN) coated implants became in recent years available for an increasing amount of total knee arthroplasty (TKA) systems. The hypothesis of this study was that the use of TiNbN-coated components would not lead to inferior results compared to conventional implants and that none of the metal hypersensitivity patients receiving TiNbN-coated implants would require revision for metal allergy. MATERIALS AND METHODS: This retrospective study compared 53 Titanium Niobium Nitride coated TKA with 103 conventional chrome cobalt implants of the same design...

The use of inert head materials such as ceramic heads has been proposed as a method of reducing wear and corrosion products from the articulating surfaces in total hip arthroplasty, as well as from the stem-head taper connection. The aim of the present study was to compare the blood metal ion levels in patients with Oxinium and CoCrMo modular femoral heads, as well as monoblock stainless steel Charnley prostheses at 10 years postoperatively. The 150 patients with osteoarthritis of the hip joint included in a randomized clinical trial were grouped according to femoral head material...

BACKGROUND: The present study aims to compare the rate of return to sports in patients who underwent surgery for mobile-bearing UKA with either hypoallergenic TiNbN or with oxidized zirconium alloy implants. METHODS: The records of two consecutive cohorts for a total of 90 hypoallergenic implants were prospectively analysed. The first cohort consisted of 41 consecutive series of medial mobile-bearing hypoallergenic TiNbN UKA, whereas the second cohort consisted of 49 consecutive medial fixed-bearing hypoallergenic Uni Oxinium...

BACKGROUND: The purpose in the present study was to compare clinical and radiological outcomes of patients who had undergone a mobile-bearing unicompartmental knee arthroplasty (UKA) with either titanium niobium nitride (TiNbN) alloy implants or with fixed-bearing oxidized zirconium alloy implants. METHODS: The records of two consecutive cohorts for a total of 86 hypoallergenic implants were prospectively analyzed. The first cohort consisted of 49 consecutive implantations of the hypoallergenic UKA Journey Uni Oxinium (Ox Group), while the second consisted of 37 consecutive series of UKA Oxford (TiNbN Group)...

Oxidized zirconium (Oxinium) implants has been claimed as the best material in terms of wear reduction. However, longevity of an all polyethylene uni knee arthroplasty (UKA) has been a long debate. We reported a rare case of 74 year old female who was performed all polyethylene UKA 6 years prior and fell 3 months prior. After the incident, patient was wheel-chair ridden afterwards. There was no evidence of fracture upon conventional radiography examination. Conversion of UKA to total knee replacement (TKA) was performed and patient was able to walk with aid after the surgery...

BACKGROUND: Femoral component fracture is a rare complication of total knee arthroplasty (TKA). CASE: We report a case of oxidized zirconium (Oxinium) femoral component fracture after total knee arthroplasty. The fracture site was the junction of the central and medial flanges. The patellar component and polyethylene insert had delamination at the contact point of the fracture line, and the tibial tray had loosening at the medial side. There was no cement adherence at the component fracture site, suggesting that debonding had occurred at the cement-implant interface in this area...

BACKGROUND: A study was performed to measure metal ions present in the knee joint after performing a total knee arthroplasty (TKA) with standard cobalt chromium (CoCr) components as well as with "nickel free" oxidized zirconium femoral and titanium tibial (OxZr/Ti) components. METHODS: Knee joint fluid was collected prior to arthrotomy and on postoperative day one to determine the amount of metal debris generated when performing a TKA with standard instrumentation from consecutive cases with CoCr components (n=24) and OxZr/Ti components (n=16)...

INTRODUCTION: While considered a satisfactory solution, unicompartmental knee arthroplasty (UKA) still raises concerns in regard to its durability. These concerns particularly focus on the tibial component. This study aims to compare two different cemented tibial components belonging to the same UKA design: all polyethylene (AP) versus metal backed (MB), at a long-term follow-up. MATERIALS AND METHODS: We retrospectively reviewed 143 successive patients, 83 of which underwent surgery with AP tibial component UKA (37 males, 46 females), and 67 with MB ones (17 males, 50 females)...

Oxinium implants are composed of a zirconium alloy with a hard ceramic surface formed by oxidization of the outer layer. This material has been shown to be an effective bearing surface for total joint arthroplasty and an alternative material for use in patients with metal hypersensitivity. Reports exist of metallosis due to unintended wear of Oxinium components from multiple mechanisms including polyethylene liner dissociation and joint instability. This metallosis creates a distinct appearance on radiographic imaging similar to that of an arthrogram...

With an increasing number of joint replacements and the evolution of orthopaedic implants and hardware, there is increased occurrence and awareness of metal-related sensitivity. This has resulted in the development of devices using a variety of different materials to coat the implant. One popular option is to cover the metallic surface with a ceramic. One commercially available ceramic-coated prosthesis is coated with oxidized zirconium, with the trade name Oxinium. Although pseudotumor and metallosis resulting from ceramic joint arthroplasty implants have been documented, there is limited information on the occurrence of metallosis resulting from ceramic-coated knee implants...

BACKGROUND: Oxidized zirconium (OxZr) offers theoretical advantages in total hip and knee arthroplasty (THA and TKA, respectively) relative to other biomaterials by combining the tribological benefits of ceramics with the fracture toughness of metals. Yet, some studies have found that OxZr does not improve outcomes or wear rates relative to traditional bearing materials such as cobalt-chromium (CoCr). Separately, effacement of the thin ceramic surface layer has been reported for OxZr components, though the prevalence and sequelae are unclear...

PURPOSE: This study prospectively reports survivorship and radiographic and clinical outcomes following primary elective total hip arthroplasty (THA) using a novel single hemispherical, porous-coated acetabular cup with five different bearing combinations and a minimum of five year follow-up. METHODS: Continuing post-market release monitoring of this cup, we prospectively enrolled 108 patients (121 THA) between 2009 and 2015. We followed this cohort by examining survivorship, in addition to clinical and radiological outcomes for metal-on-metal (MoM) compared with non-MoM bearing combinations (ceramic-on-ceramic, oxinium-on-polyethylene, ceramic-on-metal, and metal-on-polyethylene)...

BACKGROUND: Pitting damage on implants has been reported and attributed to the use of electrocautery. This study aimed to determine how different total knee arthroplasty bearing surfaces are susceptible to this type of damage and whether surgeons are aware that this damage can occur. METHODS: A survey was sent to Hip and Knee Society members to determine what percentage of adult reconstructive surgeons use electrocautery after implantation of components. Three bearing surfaces for total knee arthroplasty were selected: cobalt chromium, Oxinium, and zirconium nitride to be damaged by electrocautery with a monopolar (MP) and bipolar (BP) electrocautery with 3 different energy settings...

Total knee arthroplasty (TKA) is the final treatment for knee osteoarthritis, and 15-30% of patients show little or no improvement. This high percentage is related to aspects of the surgical technique, the selected implant, and specific patient characteristics. The aim of this study was to analyze whether there are differences in quality of life (QoL) and functional capacity among patients undergoing TKA with conventional implants compared to those treated with hypoallergenic oxinium implants. A pragmatic clinical study was carried out that included patients who underwent TKA between January 2013 and December 2015...

BACKGROUND: Oxidized zirconium (OxZi) is a relatively new type of material that combines the strength of a metal with the surface/wears properties of a ceramic. Our aim was to investigate whether OxZi femoral heads lead to lower polyethylene wear, higher survival rate, and better clinical outcomes than the other bearing types in patients treated with total hip arthroplasty (THA). METHODS: Two reviewers independently conducted a systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews...