Wear analysis of retrieved ceramic-on-ceramic articulations in total hip arthroplasty: Femoral head makes contact with the rim of the socket outside of the bearing surface

2005 ◽  
Vol 73B (2) ◽  
pp. 301-307 ◽  
Author(s):  
Tetsuya Yamamoto ◽  
Masanobu Saito ◽  
Masaru Ueno ◽  
Takehito Hananouchi ◽  
Yusuke Tokugawa ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bearing Surface ◽  
Total Hip ◽  
Wear Analysis ◽  
Ceramic On Ceramic

scholarly journals Ceramic bearings for total hip arthroplasty are associated with a reduced risk of revision for infection

2018 ◽  
Vol 28 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Rami Madanat ◽  
Inari Laaksonen ◽  
Stephen E Graves ◽  
Michelle Lorimer ◽  
Orhun Muratoglu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lower Risk ◽  
Revision Rate ◽  
Joint Infection ◽  
Bearing Surface ◽  
Related Factors ◽  
Total Hip ◽  
Reduced Risk ◽  
Ceramic On Ceramic

Introduction: Periprosthetic joint infection (PJI) is a serious complication after total hip arthroplasty (THA) and bearing material’s associations to PJI prevalence is largely unknown. The main purposes of this study were to determine if revision for infection varied depending on the type of bearing surface used in primary THA and to study whether patient or implant related factors had an effect on this variation. Methods: A total of 177,237 primary THA procedures from the Australian Registry (AOANJRR) were analysed. 3 bearing surfaces were compared. Metal-on-highly cross-linked polyethylene (MoXP) bearing had been used in 95,129 hips, ceramic-on-highly cross-linked polyethylene (CoXP) in 24,269 hips, and ceramic-on-ceramic (CoC) in 57,839 hips. Revision rates for infection were compared between the 3 groups. Results: Both MoXP and CoXP had a higher revision rate for infection compared to CoC hips (hazard ratio [HR] 1.46 (1.25, 1.72), p < 0.001) and HR 1.42 (1.15, 1.75), p = 0.001 respectively). Patients aged 70 years or less had a lower revision rate for infection when a CoC bearing was used. This difference was independent of sex, and prostheses selection. No difference was evident if the femoral component was cemented or a head size of 28 mm was used. Discussion: In this registry-based material, use of a CoC bearing was associated with a lower risk of revision for infection in patients younger than 70 years when cementless femoral components were used. Further studies are needed to verify this finding.

Ceramic-on-ceramic Total Hip Arthroplasty: Incidence and Risk Factors of Bearing Surface–related Noises in 125 Patients

Orthopedics ◽  
2012 ◽  
Vol 35 (11) ◽  
pp. e1581-e1585 ◽  
Author(s):  
Feng-Chih Kuo ◽  
Hao-Chen Liu ◽  
Wun-Schen Chen ◽  
Jun-Wen Wang
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bearing Surface ◽  
Total Hip ◽  
Ceramic On Ceramic

Fracture of a Ceramic Femoral Head After Ceramic-On-Ceramic Total Hip Arthroplasty

2006 ◽  
Vol 21 (7) ◽  
pp. 1072-1073 ◽  
Author(s):  
Manuel Malillos Torán ◽  
Jorge Cuenca ◽  
Ángel Antonio Martinez ◽  
Antonio Herrera ◽  
Javier Vicente Thomas
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Ceramic Femoral Head ◽  
Ceramic On Ceramic

scholarly journals Modular Head Mismatch in THA

2015 ◽  
Vol 5 (4) ◽  
Author(s):  
Timothy McTighe
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Biological Response ◽  
Office Visit ◽  
Direct Anterior Approach ◽  
Fretting Wear ◽  
Total Hip ◽  
Ceramic Femoral Head ◽  
Ceramic On Ceramic

Modular femoral heads have been used successfully since the mid-1980s in total hip arthroplasty. The use of metallic modular junctions presents a unique set of advantages and problems for use in total hip arthroplasty (THA). The separation of the head from the stem by a Morse taper has provided many benefits on the precision and balancing the reconstructed joint. Historically few complications have been reported for the modular Morse taper connection between the femoral head and trunnion of the stem in metal-on-polyethylene bearings. However, the risks or concerns are a little harder to identify and deal with. Certainly corrosion, and fatigue failure are the two most prevalent concerns but now the specifics of fretting wear and corrosive wear increasing particulate debris and the potential biological response is having an impact on the design and potential longevity of the reconstructed hip. This paper is dealing with a simpler consequence of head/stem modularity. Modular head mismatch to the socket bearing articulation.Two patients by two different surgeons at two different hospitals underwent cementless THA. Both patients were female and both presented with degenerative changes to the hip articulation. Both patients underwent hip replacement via a direct anterior approach using a standard hemispherical porous coated shell. One patient had a ceramic on ceramic bearing and the other had a ceramic head on a polyethylene liner. Both patients had a 32 mm inside diameter liner implanted and both had a 36 mm ceramic femoral head. The ceramic on ceramic mismatch was not recognized until the second office visit at eight weeks. The ceramic poly mismatch was not recognized until first office visit at six weeks. Both underwent correction surgery.These two cases demonstrate human mistakes can be made and steps need to be established to prevent future mistakes of this nature.

scholarly journals Fatal Cobalt Toxicity after a Non-Metal-on-Metal Total Hip Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Rinne M. Peters ◽  
Pax Willemse ◽  
Paul C. Rijk ◽  
Mels Hoogendoorn ◽  
Wierd P. Zijlstra
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
X Rays ◽  
Total Hip ◽  
Metal On Metal ◽  
Metal Wear ◽  
Cobalt Toxicity ◽  
Ceramic On Ceramic

This case illustrates the potential for systemic cobalt toxicity in non-metal-on-metal bearings and its potentially devastating consequences. We present a 71-year-old male with grinding sensations in his right hip following ceramic-on-ceramic total hip arthroplasty (THA). After diagnosing a fractured ceramic liner, the hip prosthesis was revised into a metal-on-polyethylene bearing. At one year postoperatively, X-rays and MARS-MRI showed a fixed reversed hybrid THA, with periarticular densities, flattening of the femoral head component, and a pattern of periarticular metal wear debris and pseudotumor formation. Before revision could take place, the patient was admitted with the clinical picture of systemic cobalt toxicity, supported by excessively high serum cobalt and chromium levels, and ultimately died. At autopsy dilated cardiomyopathy as cause of death was hypothesized. A third body wear reaction between ceramic remnants and the metal femoral head very likely led to excessive metal wear, which contributed systemic cobalt toxicity leading to neurotoxicity and heart failure. This case emphasizes that fractured ceramic-on-ceramic bearings should be revised to ceramic-on-ceramic or ceramic-on-polyethylene bearings, but not to metal-on-polyethylene bearings. We aim to increase awareness among orthopedic surgeons for clinical clues for systemic cobalt intoxication, even when there is no metal-on-metal bearing surface.

Ceramic-on-ceramic total hip arthroplasty in patients with osteonecrosis of the femoral head

2011 ◽  
Vol 22 (5) ◽  
pp. 432-436
Author(s):  
Jae Ho Jung ◽  
Tong Joo Lee ◽  
Su Yeon Kim ◽  
Sae Rom Jung ◽  
Kyoung Ho Moon
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Ceramic On Ceramic
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