scholarly journals Ceramic bearings fracture: a literature review on risk factors, diagnosis, and treatment

2020 ◽  
pp. 1-7 ◽  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Young Patients ◽  
Revision Arthroplasty ◽  
Ceramic Component ◽  
Total Hip ◽  
Ceramic Bearing ◽  
Ceramic Components

Ceramic surfaces are commonly used in total hip arthroplasty (THA) in young patients due to their good tribological properties. Nonetheless, the fracture of ceramic components is among the most demanding complications of total hip arthroplasty. Ceramic failure is a matter of emergency and needs urgent revision arthroplasty. In this regard, the present study aimed to better understand how to diagnose a ceramic component fracture, identify the major risk factors for the fracture of ceramic components, and analyze the different techniques used in revision arthroplasty for ceramic bearing failure. The literature search was performed on PubMed, MEDLINE-Ovid, and Cochrane Reviews. The search keywords included ceramic fracture, ceramic failure, and ceramic arthroplasty revision surgery. A number of 47 articles were selected out of 126 articles found in the initial research. X-ray and computed tomography (CT) scan must be utilized on suspicion of ceramic component fracture. The most relevant risk factor for head fracture is short neck and 28-mm head combination. Moreover, acetabular cup malpositioning and liner misalignment during insertion are the two major risk factors for liner fracture. There is no consensus on the best revision treatment strategy. Nonetheless, it is necessary to perform a complete synovectomy and an accurate cleaning of the hip joint before the implant of the new components. Stability, integrity, and positioning of both femoral and acetabular components must be evaluated during surgery. If damaged, even well-fixed components should be removed. New ceramic bearing surface is the best option, whereas metal is not recommended for revision surgery.

Epidemiological Study of Femoral Head Osteonecrosis

2017 ◽  
Vol 68 (5) ◽  
pp. 974-976
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Victor Grigorescu ◽  
carmen Grierosu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Head Group ◽  
Bipolar Hemiarthroplasty ◽  
Aseptic Necrosis ◽  
Total Hip ◽  
Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

Ten-year survivorship of primary total hip arthroplasty in patients 30 years of age or younger

2018 ◽  
Vol 100-B (7) ◽  
pp. 867-874 ◽  
Author(s):  
C. A. Makarewich ◽  
M. B. Anderson ◽  
J. M. Gililland ◽  
C. E. Pelt ◽  
C. L. Peters
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Cox Regression ◽  
Revision Rate ◽  
Young Patients ◽  
Revision Arthroplasty ◽  
The Elderly ◽  
Total Hip ◽  
Patient Reported

Aims For this retrospective cohort study, patients aged ≤ 30 years (very young) who underwent total hip arthroplasty (THA) were compared with patients aged ≥ 60 years (elderly) to evaluate the rate of revision arthroplasty, implant survival, the indications for revision, the complications, and the patient-reported outcomes. Patients and Methods We retrospectively reviewed all patients who underwent primary THA between January 2000 and May 2015 from our institutional database. A total of 145 very young and 1359 elderly patients were reviewed. The mean follow-up was 5.3 years (1 to 18). Logistic generalized estimating equations were used to compare characteristics and the revision rate. Survival was evaluated using Kaplan–Meier curves and hazard rates were created using Cox regression. Results The overall revision rate was 11% (16/145) in the very young and 3.83% (52/1359) in the elderly groups (odds ratio (OR) 2.58, 95% confidence interval (CI) 1.43 to 4.63). After adjusting for the American Society of Anesthesiologists (ASA) score, gender, and a history of previous surgery in a time-to-event model, the risk of revision remained greater in the very young (adjusted hazard ratio (HR) 2.48, 95% CI 1.34 to 4.58). Survival at ten years was 82% (95% CI, 71 to 89) in the very young and 96% (95% CI, 94 to 97) in the elderly group (p < 0.001). The very young had a higher rate of revision for complications related to metal-on-metal (MoM) bearing surfaces (p < 0.001). At last follow-up, the very young group had higher levels of physical function (p = 0.002), lower levels of mental health (p = 0.001), and similar levels of pain (p = 0.670) compared with their elderly counterparts. Conclusion The overall revision rate was greater in very young THA patients. This was largely explained by the use of MoM bearings. Young patients with non-MoM bearings had high survivorship with similar complication profiles to patients aged ≥ 60 years. Cite this article: Bone Joint J 2018;100-B:867–74.

scholarly journals Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Paweł Łęgosz ◽  
Maciej Otworowski ◽  
Aleksandra Sibilska ◽  
Krzysztof Starszak ◽  
Daniel Kotrych ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Heterotopic Ossification ◽  
Hip Arthroplasty ◽  
Previous History ◽  
Revision Arthroplasty ◽  
Total Hip ◽  
History Of ◽  
Turnover Markers ◽  
The One

Background. This review is intended to summarize the risk factors, classification, diagnosis, and treatment of heterotopic ossification (HO) of previously published studies. Results. Heterotopic ossification is a common complication of total hip arthroplasty. Its prevalence is not the same in all of the patient groups. Frequency of HO varies from 15 to 90%. Hip ankylosis, male gender, and previous history of HO are said to be risk factors with a significant level. Diagnosis is based on a single AP radiograph: the Brooker classification that divides HO into four grades is the most commonly used. The confirmation test that can be used is a bone scan. A great amount of bone metabolic turnover markers have been tested, but none of them seems to be relevant in case of prevention or diagnosis of HO. The most effective prophylactic treatment is radiotherapy or administration of nonsteroidal anti-inflammatory drugs. Over the years a lot of different RT protocols have been tested. Nowadays the most often used regimen is 7 Gy given postoperatively in a single dose. The most commonly prescribed drug in prophylaxis of HO is indomethacin. Also, the efficacy of ibuprofen and diclofenac was proven. Recently researchers focused on selective COX-2 inhibitors. They appear to be as effective as nonselective NSAIDs having less side effects. The one and only treatment of HO is a revision arthroplasty.

Cementless total hip arthroplasty in young patients under the age of 30: a minimum 10-year follow-up

2018 ◽  
Vol 28 (5) ◽  
pp. 507-513 ◽  
Author(s):  
Eun Ho Shin ◽  
Kyoung Ho Moon
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Revision Arthroplasty ◽  
Activity Level ◽  
Head Size ◽  
Harris Hip Score ◽  
Total Hip ◽  
The Mean

Purpose: The purpose of this study was to evaluate the clinical and radiologic outcomes of young patients (under the age of 30) who received a total hip arthroplasty (THA) and in whom patients had been followed for more than 10 years. Materials and methods: This retrospective study was conducted for 51 hips (44 patients) that had undergone THA. The mean age for the index operation was 25.71 years, and the mean follow-up period was 13.7 years. Clinical outcomes were evaluated by Harris hip score (HHS), activity level, and complications. Radiographic evaluations were assessed according to osteolysis, loosening, and polyethylene wear. Results: The average HHS improved from 67.47 pre-operatively to 97.42 at the final follow-up ( p < 0.001). The activity level changed from 1.92 pre-operatively to 1.33 at the final follow-up ( p < 0.001). Ten cases had undergone revision arthroplasty within the follow-up period, and the overall survival rate was 80.4% at the final follow-up with revision for any reason as the end point. Polyethylene liners were used in all revision cases ( p = 0.003). Patients with modular stem had a higher failure rate than patients with a fully porous coated stem ( p < 0.001). Furthermore, a small diameter head size was associated with a higher risk of revision surgery ( p = 0.003). Complications such as dislocations were found in three hips. Conclusion: Cementless THA yields encouraging clinical and radiological results in young and active patients under the age of 30. However, the bearing surface, type of stem, and head size influenced component durability and revision rate.

Cementless total hip arthroplasty with delta-on-delta ceramic bearing in patients younger than 30 years

2019 ◽  
pp. 112070001988959
Author(s):  
Young-Kyun Lee ◽  
Ki-Choul Kim ◽  
Byung-Ho Yoon ◽  
Tae-Young Kim ◽  
Yong-Chan Ha ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Harris Hip Score ◽  
Registration System ◽  
Ceramic Fracture ◽  
Total Hip ◽  
Ceramic Bearing ◽  
The Mean

Background: Despite improvements in the mechanical properties of alumina ceramics, the outcome of total hip arthroplasty (THA) with contemporary ceramic bearings in young patients remains a matter of concern. We evaluated the results of cementless THA with the use of the delta ceramic bearing, and determined the prevalence of osteolysis, squeaking, and ceramic fracture in patients aged < 30 years at mid-term. Methods: From March 2008 to January 2012, 76 consecutive patients (91 hips), younger than 30 years, underwent cementless THA with Delta ceramic bearings. In each follow-up, the clinical evaluation including noise and radiological evaluations were recorded. Results: Among them, 72 patients (86 THAs) were followed-up for a minimum of 5 years (mean 70.8; 60−95.9 months). There were 44 men (47 hips) and 28 women (39 hips). The mean age at the time of the index arthroplasty was 25.9 (16−30) years and the mean preoperative Harris Hip Score (HHS) was 59.4 (23−79) points. HHS improved to 96.3 (64−100) points at the final follow-up evaluation. 8 hips (9.3%) exhibited grinding or squeaking. No hip had aseptic loosening and no hip was revised. No osteolysis was detected around any acetabular or femoral components. Conclusions: Our results suggest that cementless THA with the use of Delta ceramic bearing provides satisfactory results without osteolysis or ceramic fracture in patients aged <30 years at a mid-term follow-up. Clinical Trials.gov Protocol Registration System (trial no. NCT01838096).

scholarly journals Fracture of Ceramic Bearing Surfaces following Total Hip Replacement: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Francesco Traina ◽  
Marcello De Fine ◽  
Alberto Di Martino ◽  
Cesare Faldini
Keyword(s):  
Systematic Review ◽  
Early Diagnosis ◽  
Total Hip Replacement ◽  
Revision Surgery ◽  
Hip Replacement ◽  
Ceramic Component ◽  
Component Failure ◽  
Total Hip ◽  
Ceramic Bearing ◽  
Ceramic Components

Ceramic bearing surfaces are increasingly used for total hip replacement, notwithstanding that concern is still related to ceramic brittleness and its possible mechanical failure. The aim of this systematic review is to answer three questions: (1) Are there risk factors for ceramic component fracture following total hip replacement? (2) Is it possible to perform an early diagnosis of ceramic component failure before catastrophic fracture occurs? (3) Is it possible to draw guidelines for revision surgery after ceramic components failure? A PubMed and Google Scholar search was performed and reference citations from publications identified in the literature search were reviewed. The use of 28 mm short-neck femoral head carries an increased risk of fracture. Acetabular component malposition might increase the risk of ceramic liner fractures. Synovial fluid microanalysis and CT scan are promising in early diagnosis of ceramic head and liner failure. Early revision is suggested in case of component failure; no consensus exists about the better coupling for revision surgery. Ceramic brittleness remains a major concern. Due to the increased number of ceramic on ceramic implants, more revision surgeries and reports on ceramic components failure are expected in the future. An algorithm of diagnosis and treatment for ceramic hip failure is proposed.

Incidence, Risk Factors, and Outcome of Ceramic-On-Ceramic Bearing Breakage in Total Hip Arthroplasty

2021 ◽  
Author(s):  
Wayne Hoskins ◽  
Sophia Rainbird ◽  
Yi Peng ◽  
Michelle Lorimer ◽  
Stephen E. Graves ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Ceramic Bearing ◽  
Incidence Risk ◽  
Ceramic On Ceramic
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