Atraumatic Delta Head Fracture in a Ceramic-On-Polyethylene Total Hip Arthroplasty

2017 ◽  
Vol 01 (02) ◽  
pp. 118-120 ◽  
Author(s):  
Sameer Oak ◽  
Salvatore Frangiamore ◽  
Carlos Rueda ◽  
Robert Molloy ◽  
Alison Klika

AbstractA 47-year-old man underwent a left ceramic-on-polyethylene total hip arthroplasty with a delta ceramic femoral head. At 20 months postoperatively, he presented with acute left groin pain after he stepped over a fishing rod while on a boat. A fracture of the femoral head without trauma was diagnosed upon presentation. Manufacturing practices with improvements in each successive generation have decreased historically high ceramic fracture rates considerably. Although femoral head fractures have proven to be extremely rare both in ceramic-on-polyethylene articulations and with the newest delta femoral head, it is important to remain vigilant in all situations involving ceramics.

2012 ◽  
Vol 529-530 ◽  
pp. 279-284 ◽  
Author(s):  
Taishi Sato ◽  
Yasuharu Nakashima ◽  
Mio Akiyama ◽  
Takuaki Yamamoto ◽  
Taro Mawatari ◽  
...  

The purpose of this study was to examine the effects of ceramic femoral head material on the wear of annealed, crosslinked ultra-high molecular weight polyethylene (UHMWPE) (XLPE) in total hip arthroplasty compared to non-crosslinked conventional UHMWPE (CPE). XLPE was fabricated by crosslinking with 60 kGy irradiation and annealing. Femoral heads made from zirconia and alumina ceramics, and cobalt-chrome (CoCr) of 22 mm or 26 mm diameter were used. In this study, the femoral head penetration into the cup was measured digitally on radiographs of 70 hips with XLPE and 50 hips with CPE. The average follow-up periods were 6.1 and 12.7 years, respectively. The steady wear rate of XLPE was significantly lower than those of CPE (0.002 versus 0.08 mm/year, respectively). Zirconia displayed increased wear rates compared to alumina in CPE; however, there was no difference among head materials in XLPE (0.0028, 0.011 and 0.009 mm/year for zirconia, alumina and CoCr, respectively). Neither head size or implantation period impacted XLPE wear. In contrast to CPE, XLPE displayed low wear rates surpassing the effects of varying femoral head material, size, implantation period and patient demographics.


1999 ◽  
Vol 81 (10) ◽  
pp. 1446-9 ◽  
Author(s):  
BRADLEY K. VAUGHN ◽  
THOMAS B. DAMERON ◽  
THOMAS W. BAUER ◽  
YUICHI MOCHIDA ◽  
TOSHIHIRO AKISUE ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Tomoya Takasago ◽  
Tomohiro Goto ◽  
Keizo Wada ◽  
Daisuke Hamada ◽  
Toshiyuki Iwame ◽  
...  

The type of bearing material that should be used in revision surgery after the failure of ceramic-on-ceramic total hip arthroplasty (THA) remains controversial. In the case of ceramic fracture, the residual ceramic particles can cause consequent metallosis when metal implants are used for revision THA. On the other hand, in the case of THA failure without ceramic fracture, revision THA with a metal femoral head provides satisfactory results. We report an unusual case of progressive osteolysis due to metallosis that developed after revision THA for ceramic liner dissociation without a liner fracture performed using a metal femoral head and polyethylene liner. The residual metal debris and abnormal pumping motion of the polyethylene liner due to the breakage of the locking system or the aspherical metal shell being abraded by the ceramic head seemed to be the cause of the progressive osteolysis.


2003 ◽  
Vol 85 (5) ◽  
pp. 825-830 ◽  
Author(s):  
JÉRÔME ALLAIN ◽  
FRANÇOISE ROUDOT-THORAVAL ◽  
JOEL DELECRIN ◽  
PHILIPPE ANRACT ◽  
HENRI MIGAUD ◽  
...  

2006 ◽  
Vol 21 (7) ◽  
pp. 1072-1073 ◽  
Author(s):  
Manuel Malillos Torán ◽  
Jorge Cuenca ◽  
Ángel Antonio Martinez ◽  
Antonio Herrera ◽  
Javier Vicente Thomas

2003 ◽  
Vol 52 (2) ◽  
pp. 376-380
Author(s):  
Kenji Tsunoda ◽  
Masamori Shigematsu ◽  
Toshimitsu Koga ◽  
Yukihiko Tsutsumi ◽  
Takao Hotokebuchi

2002 ◽  
Vol 12 (2) ◽  
pp. 142-149 ◽  
Author(s):  
T. Scheerlinck ◽  
M. Dezillie ◽  
A. Monsaert ◽  
P. Opdecam

The authors evaluate medium-term results of bipolar and total hip arthroplasty as a treatment for avascular necrosis of the femoral head. Between 1990 and 2000, 57 hips (45 patients) were treated with a bipolar (BHA: 37 hips) or total hip arthroplasty (THA: 20 hips) depending on the radiographic and macroscopic aspect of the acetabulum. At surgery, all patients were under 65 years of age (average: 45.09 years). All had the same cementless hydroxylapatite coated femoral stem inserted through an anterolateral approach. The BHA were followed during a mean of 4.49 years. One BHA was lost to follow-up. Seven out of 36 hips (19.44%) were considered failures: three due to a poor functional result (Harris Hip Score (HHS) <70) and four which needed conversion to THA for groin pain. Two hips were revised for periprosthetic fracture. Twenty BHA (55.56%) had a good or excellent result (HHS 80). The THA were followed for a mean of 4.32 years. One THA was lost to follow-up. Four out of 19 hips (21.05%) were considered as failures. Three due to a poor functional result (HHS<70) and one which needed cup revision for recurrent dislocation. Fifteen THA (78.95%) had a good or excellent functional result (HHS80). BHA as a treatment of avascular necrosis of the femoral head in young patients preserves bone stock for later revisions and can lead to excellent results. But the outcome seems less predictable than after THA. Groin pain associated to BHA can be treated successfully with conversion to THA if necessary.


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