Wear of the Cup. 22.225 mm Alumina Ceramic Head, Charnley Femoral Component and Cross-Linked Polyethylene Cup

In total hip prosthesis (THP), we have been using alumina ceramic femoral heads to reduce polyethylene debris and the modified cementing technique, which was named “interface bioactive bone cement (IBBC)” method to improve implant fixation. In this study, we investigated the long-term clinical performance of THPs with an alumina ceramic head and IBBC method. From 1986 to 1988, 285 joints (215 patients) were operated on by a senior surgeon, and 265 joints (192 patients) could be followed up. The presence of radiolucent lines, loosening, osteolysis and ultrahigh-molecular-weight polyethylene (UHMWPE) socket wear were observed. In IBBC, a radiolucent line appeared as a ’space’, and loosening appeared as a ’separation’ between the HA layer and the cement. A ‘space’ appeared in 3 joints (1.4%) on the acetabulum and in 4 joints (1.8%) on the femur, while a ‘separation’ appeared in 3 joints (1.4%) on the acetabulum. Osteolysis was noted in 1 joint (0.5%) on the acetabulum and in 2 joints (0.9%) on the femur. No revision surgery was required. In our previous study, we reported that the thickness of the socket affected its clinical wear rate and that the wear rate of sockets with an alumina ceramic head was 20% lower than that of sockets with a metal head. By reducing wear debris through the use of ceramic heads, osteolysis could be reduced. Long-term fixation of THPs to the bone has been achieved by using IBBC. Thus, the long-term clinical results of THPs with an alumina head that were fixed using IBBC were excellent.

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Fracture of an alumina ceramic head in total hip arthroplasty

The Journal of Arthroplasty ◽

10.1016/s0883-5403(05)80086-5 ◽

1995 ◽

Vol 10 (6) ◽

pp. 851-854 ◽

Cited By ~ 54

Author(s):

F. Higuchi ◽

N. Shiba ◽

A. Inoue ◽

I. Wakebe

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Alumina Ceramic ◽

Ceramic Head ◽

Total Hip

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Fracture of alumina ceramic head in total hip arthroplasty-report of two cases with histological examination and particle characterisation

Bioceramics ◽

10.1016/b978-008042692-1/50072-8 ◽

1997 ◽

pp. 305-307

Author(s):

Y. Kadoya ◽

A. Kobayashi ◽

P.A. Revell ◽

H. Ohashi ◽

Y. Yamano ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Histological Examination ◽

Hip Arthroplasty ◽

Alumina Ceramic ◽

Ceramic Head ◽

Total Hip ◽

Particle Characterisation

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Analysis of 18F-FDG uptake patterns in PET for diagnosis of septic and aseptic loosening after total hip arthroplasty

Nuklearmedizin ◽

10.1055/s-0038-1625733 ◽

2003 ◽

Vol 42 (06) ◽

pp. 234-239 ◽

Cited By ~ 21

Author(s):

T. Mumme ◽

P. Reinartz ◽

D. Wirtz ◽

F. U. Niethard ◽

U. Büll ◽

...

Keyword(s):

Aseptic Loosening ◽

Femoral Component ◽

Hip Prosthesis ◽

Prosthetic Infection ◽

Clinical Value ◽

Septic Loosening ◽

Hip Prostheses ◽

Fdg Uptake ◽

Positron Emission ◽

Painful Hip

Summary Aim: Identification of typical patterns for fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) to detect aseptic loosening of hip prosthesis (ace-tabular and/or femoral component) and prosthetic infection. Methods: 18 patients with painful hip prosthesis underwent PET using a dedicated full ring scanner after application of 200-300 MBq FDG. The interface between bone and surrounding soft tissue or bone as displayed on coronal slices was divided into 12 segments in accordance with the classifications of Delee and Gruen. FDG uptake in each of the segments was scored (0-3) by two independent observers. Intraoperative findings were regarded as the gold standard. Results: After surgical revision 14 acetabular components and 9 femoral components were found to be loose and prosthetic infection was present in 7 prostheses. Loosening of the acetabular component was correlated to enhanced uptake in the middle of the acetabular interface, while loosening of the femoral component was correlated to enhanced uptake in the proximal and middle segment of the lateral femoral interface and the proximal segment of the medial femoral interface. A similar pattern was found in prosthetic infection with high uptake along the middle portion of the lateral fe-moral interface. In 6 of 7 infected prostheses loosening of the acetabular and of the femoral component was present. Taking the typical uptake patterns as criteria for loosening and grade 3 uptake as an additional criterion for septic loosening the accuracy of PET imaging in the detection of loosening of the acetabular or the femoral component and of prosthetic infection was 72, 78 and 89%, respectively. Conclusion: This pilot study presents FDG-PET as a promising diagnostic tool for patients with painful hip prostheses. Its clinical value should be evaluated in a larger patient population.

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Isolated Liner Revision for Total Knee Arthroplasty Instability: A Road That Should Remain Less Taken

The Journal of Knee Surgery ◽

10.1055/s-0040-1721091 ◽

2020 ◽

Author(s):

Jason D. Tegethoff ◽

Rafael Walker-Santiago ◽

William M. Ralston ◽

James A. Keeney

Keyword(s):

Total Knee Arthroplasty ◽

Femoral Component ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

P Value ◽

Surgical Morbidity ◽

Exact Test ◽

Total Knee ◽

Component Revision

AbstractIsolated polyethylene liner exchange (IPLE) is infrequently selected as a treatment approach for patients with primary total knee arthroplasty (TKA) prosthetic joint instability. Potential advantages of less immediate surgical morbidity, faster recovery, and lower procedural cost need to be measured against reoperation and re-revision risk. Few published studies have directly compared IPLE with combined tibial and femoral component revision to treat patients with primary TKA instability. After obtaining institutional review board (IRB) approval, we performed a retrospective comparison of 20 patients treated with IPLE and 126 patients treated with tibial and femoral component revisions at a single institution between 2011 and 2018. Patient demographic characteristics, medical comorbidities, time to initial revision TKA, and reoperation (90 days, <2 years, and >2 years) were assessed using paired Student's t-test or Fisher's exact test with a p-value <0.01 used to determine significance. Patients undergoing IPLE were more likely to undergo reoperation (60.0 vs. 17.5%, p = 0.001), component revision surgery (45.0 vs. 8.7%, p = 0.002), and component revision within 2 years (30.0 vs. 1.6%, p < 0.0001). Differences in 90-day reoperation (p = 0.14) and revision >2 years (p = 0.19) were not significant. Reoperation for instability (30.0 vs. 4.0%, p < 0.001) and infection (20.0 vs. 1.6%, p < 0.01) were both higher in the IPLE group. IPLE does not provide consistent benefits for patients undergoing TKA revision for instability. Considerations for lower immediate postoperative morbidity and cost need to be carefully measured against long-term consequences of reoperation, delayed component revision, and increased long-term costs of multiple surgical procedures. This is a level III, case–control study.

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Porous Alumina Ceramic Prepared by HEMA-TBA Gelcasting System

Journal of Inorganic Materials ◽

10.15541/jim20160550 ◽

2017 ◽

Vol 32 (7) ◽

pp. 731 ◽

Cited By ~ 1

Author(s):

XIE Yu-Zhou ◽

PENG Chao-Qun ◽

WANG Xiao-Feng ◽

WANG Ri-Chu ◽

LUO Feng

Keyword(s):

Porous Alumina ◽

Alumina Ceramic

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