Ceramic-On-Ceramic Implants in Total Hip Arthroplasty

2005 ◽  
Vol 284-286 ◽  
pp. 1003-1006
Author(s):  
Clifford W. Colwell ◽  
J.A. D'Antonio ◽  
W.N. Capello ◽  
M.E. Hardwick
Keyword(s):  
Ceramic Materials ◽  
Clinical Results ◽  
Alumina Ceramic ◽  
Harris Hip Score ◽  
X Rays ◽  
Cobalt Chromium ◽  
Ceramic Implants ◽  
Receive System ◽  
Clinical And Radiological Results ◽  
Ceramic On Ceramic

Alumina ceramic is an excellent material for biologic implantation. Decreased particulate wear debris should increase implant longevity. The purpose of this study is to examine clinical and radiological results of ceramic-on-ceramic hip implants compared to cobalt chrome on polyethylene. Four cementless systems were compared, three alumina-on-alumina bearing systems: System I, porous coated cup; System II, hydroxyapatite-coated cup; Trident system, hydroxyapatite-coated cup with metal sleeve backing on ceramic cup liner; and System III (control), porous-coated cup with polyethylene and cobalt chromium bearing system. Patients were randomized to receive System I, II, or III. Trident patients were not randomized. Examinations are performed at 6 months, 1 year and yearly thereafter including x-rays, clinical exam and Harris Hip Score (HHS). Minimum 24-month followup was performed in 562 ceramic hips and 154 control hips. Age, height, weight, gender and diagnosis were similar in all groups. HHS was rated good/excellent by 95 percent of ceramic hips and 97 percent of control hips. Radiographic results demonstrated radiolucency in Femoral Gruen Zone 1 in 3.8 percent (18/474) of ceramic hips and in 8 percent (10/128) of control hips. Unstable acetabular components were reported in none of ceramic hips and in 3.2 percent (5/154) of control hips. Revision was performed in 7 (1.2 percent) ceramic hips, none due to failure of ceramic materials, and in 9 (5.8 percent) control hips. Alumina ceramic materials show promise, but continued evaluation of long-term clinical results is needed.

Hydroxyapatite Ceramic Hip Survey: Ceramic/Ceramic Bearings

2007 ◽  
Vol 361-363 ◽  
pp. 1283-1286
Author(s):  
James M. Buchanan ◽  
Sally Goodfellow
Keyword(s):  
Histological Examination ◽  
Clinical Application ◽  
Alumina Ceramic ◽  
Harris Hip Score ◽  
X Rays ◽  
Post Mortem ◽  
Hydroxyapatite Ceramic ◽  
Ceramic Components ◽  
Zirconia Toughened Alumina

This paper describes the clinical application of alumina ceramic and, more recently, Zirconia Toughened Alumina (ZTA), to the bearing surfaces of hip implants with a maximum follow up of fifteen years. Patients are assessed pre- and post-operatively using the Harris Hip Score. [1] X-rays are taken annually and, where appropriate, post mortem histological examination is carried out. Results are discussed. Some failures of alumina ceramic components have been seen and measures to prevent such incidents are described.

scholarly journals Two- to 9-Year Clinical Results of Alumina Ceramic-on-Ceramic THA

2006 ◽  
Vol 453 ◽  
pp. 97-102 ◽  
Author(s):  
Stephen B Murphy ◽  
Timo M Ecker ◽  
Moritz Tannast
Keyword(s):  
Clinical Results ◽  
Alumina Ceramic ◽  
Ceramic On Ceramic

Investigation of Aged Dispersion Ceramics by Means of Hip Simulator

2007 ◽  
Vol 361-363 ◽  
pp. 771-774 ◽  
Author(s):  
Thomas Oberbach ◽  
Sabine Begand ◽  
Wilfried Glien ◽  
Christian Kaddick
Keyword(s):  
Life Expectancy ◽  
Ceramic Materials ◽  
Alumina Ceramic ◽  
Zirconia Ceramic ◽  
Tribological Behaviour ◽  
Artificial Joints ◽  
Hip Simulator ◽  
Zirconia Toughened Alumina ◽  
Ceramic On Ceramic

Wear of hip implants is a significant problem for the life expectancy of artificial joints. By using alumina ceramic on ceramic couplings the wear can be decreased. But for further improvement of the safety of THR the aim is the development of new ceramic materials. For orthopaedic applications an Alumina Toughened Zirconia Ceramic ATZ (80% ZrO2-20%Al2O3) and a Zirconia Toughened Alumina ZTA (25% ZrO2-75%Al2O3) were tested regarding their tribological behaviour by means of hip simulator testing after hydrothermal treatment. The absolute wear amount for the aged samples after 5 million cycles is slightly increased on a very low level, but even less wear than for common alumina pairings. In consideration of these excellent results both dispersion ceramics are highly suitable for long term applications.

scholarly journals The Reconstruction Accuracy of the Hip Center of Rotation After Cementless Total Hip Arthroplasty for Failed Treatment of Acetabular Fractures. Does It Matter?

2021 ◽  
Author(s):  
Liang Zhang ◽  
Mingxue Chen ◽  
Zhuyi Ma ◽  
Tao Bian ◽  
Shaoliang Li ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Acetabular Fractures ◽  
X Rays ◽  
Reconstruction Accuracy ◽  
Center Of Rotation ◽  
Total Hip ◽  
Radiographic Outcomes ◽  
Negative Effect ◽  
Hip Arthroplasties

Abstract Background To assess the impaction of reconstruction accuracy of hip center of rotation (COR) on midterm clinical and radiographic results of cementless reconstruction of total hip arthroplasties (THAs) for patients after failed treatment of acetabular fractures. Methods One hundred and four patients (107 hips) who underwent THAs after failed treatment of acetabular fractures were retrospectively evaluated and cementless cups and stems were implanted in all hips. Clinical outcomes were assessed using the Harris hip score (HHS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scoring system. Radiographic results were analyzed by serial perioperative x-rays. Results At the latest follow-up examination, the median HHS increased from 52 (42-65) before surgery to 93 (90-97) (p < 0.001) and the median WOMAC decreased from 52 (36-65) before surgery to 5.8 (1.5-8) (p < 0.001). Compared with normal contralateral hip, 79 cups migrated superiorly (0.2-33.6mm) and 22 cups migrated inferiorly (0.2-16.1mm). The distance of superior migration of reconstructed COR was correlated with positive Trendelenburg sign at the latest follow-up examination (r=0.504; p < 0.001). The percentage of postoperative Trendelenburg sign was significantly higher in superior migration subgroup than that in subgroup with anatomical restoration of COR (P=0.015). Conclusions Cementless THAs in patients after failed treatment for acetabular fractures achieved predictable clinical and radiographic outcomes. A superiorly migrated hip COR appeared to exert a negative effect on abductor muscle function.

Preparation of Macroporous Ceramic Materials by Using Aluminium Powder as Foaming Agent

2014 ◽  
Vol 699 ◽  
pp. 336-341 ◽  
Author(s):  
Nurulfazielah Nasir ◽  
Ridhwan Jumaidin ◽  
Hady Efendy ◽  
Mohd Zulkefli Selamat ◽  
Goh Keat Beng ◽  
...  
Keyword(s):  
Ceramic Material ◽  
Reaction Rate ◽  
Porous Alumina ◽  
Porous Ceramic ◽  
Ceramic Materials ◽  
Calcium Sulphate ◽  
Alumina Ceramic ◽  
Deionized Water ◽  
Foaming Agent ◽  
Aluminium Powder

Aluminium powder was used as foaming agent in the production of macro-porous alumina ceramic. The porous ceramic material was developed by mixing an appropriate composition of cement, aluminium powder (Al), alumina (Al2O3), calcium oxide (CaO), gypsum (calcium sulphate dehydrate, CaSO4.2H2O), silica powder and deionized water. Different compositions of porous ceramic were produced at 2wt.%, 3wt.% and 4wt.% of aluminium powder. Their mechanical properties and macro-porosity structural of the porous ceramic material were analysed and compared. It is determined that the optimal properties of porous ceramic material were found at 3wt.% of aluminium powder and degraded drastically at 4wt.%. This phenomenon is due to the chemical reaction between the aluminium powder and DI water in which they form aluminium oxide that promotes the strength of the material but at the same time, more pores are created at higher reaction rate between these two fundamental materials.

scholarly journals Preliminary Results in Anatomic All-inside Anterior Cruciate Ligament Reconstruction

2016 ◽  
Vol 1 (s2) ◽  
pp. 23-26
Author(s):  
Octav Russu ◽  
Tiberiu Bățagă ◽  
Andrei-Marian Feier ◽  
Radu Prejbeanu ◽  
Radu Fleaca ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Clinical Results ◽  
Lysholm Score ◽  
X Rays ◽  
The Mean ◽  
Anterior Cruciate

Abstract Introduction: Anterior cruciate ligament (ACL) rupture is one of the most common lesions in knee traumatology; therefore the number of ACL reconstructions is increasing worldwide. Usually, an anteromedial (AM) accessory portal is required in anatomical positioning of the femoral tunnel, which is not absolutely necessary in this technique. Aim: Assessment of all-inside ACL reconstruction preliminary clinical results with adjustable loops and buttons on both femoral and tibial surfaces. Method: Our prospective study included 28 subjects (19 male, 9 female) with chronic ACL ruptures. The mean age of the study population was 27.72 ± 8.23 years. In all cases ACL reconstruction was carried out with the use of quadrupled semitendinosus auto-grafts with adjustable loops and buttons on the femoral and tibial surfaces and anatomic placement of both tunnels, using an outside-in technique, with flipcutters (Arthrex®). Clinical and radiological evaluations were carried out before surgery and at 3 and 6 months postoperatively, with the Lysholm scoring system, the Tegner activity scale and anterior-posterior and latero-lateral X-rays. Anterior knee laxity was measured in 25° of flexion using a portable arthrometer (RolimeterTM, Aircast®) and maximum manual force. Results: During the final follow-up, the Lysholm score was good and excellent in 27 cases, with a mean Lysholm score of 95.55 ± 4.63; all results were classified as good. The mean preoperative Tegner activity score was 3.46 ± 1.71 (range: 1-7), and the post-operative mean score was 5.75 ± 2.24 (range: 2-10). We found no graft ruptures. Preoperative knee laxity measurements showed a mean displacement of 11.5 ± 3.1 mm and side-to-side differences of 5.6 ± 3.5 mm, while the postoperative measurements at the last follow-up were 6.3 ± 1.54 mm and 2.65 ± 1.86 mm, respectively. Conclusion: Short-term clinical outcomes of all-inside ACL restoration with anatomic placement femoral and tibial tunnels seem to recommend this surgical option, with good subjective and objective results. Additional research will have to prove the long-term success.

scholarly journals Carbon Ion Radiobiology

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3022 ◽  
Author(s):  
Walter Tinganelli ◽  
Marco Durante
Keyword(s):  
Normal Tissue ◽  
Biological Response ◽  
Metastatic Potential ◽  
Clinical Results ◽  
Heavy Ion ◽  
Particle Therapy ◽  
X Rays ◽  
Carbon Ions ◽  
Treatment Protocols ◽  
Target Region

Radiotherapy using accelerated charged particles is rapidly growing worldwide. About 85% of the cancer patients receiving particle therapy are irradiated with protons, which have physical advantages compared to X-rays but a similar biological response. In addition to the ballistic advantages, heavy ions present specific radiobiological features that can make them attractive for treating radioresistant, hypoxic tumors. An ideal heavy ion should have lower toxicity in the entrance channel (normal tissue) and be exquisitely effective in the target region (tumor). Carbon ions have been chosen because they represent the best combination in this direction. Normal tissue toxicities and second cancer risk are similar to those observed in conventional radiotherapy. In the target region, they have increased relative biological effectiveness and a reduced oxygen enhancement ratio compared to X-rays. Some radiobiological properties of densely ionizing carbon ions are so distinct from X-rays and protons that they can be considered as a different “drug” in oncology, and may elicit favorable responses such as an increased immune response and reduced angiogenesis and metastatic potential. The radiobiological properties of carbon ions should guide patient selection and treatment protocols to achieve optimal clinical results.

scholarly journals Arthroscopic treatment of internal snapping hip

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0017
Author(s):  
Gonzalo J. Magi ◽  
Juan Pablo Carucci ◽  
Sebastián Bergués
Keyword(s):  
Recurrence Rate ◽  
Clinical Results ◽  
Arthroscopic Treatment ◽  
Harris Hip Score ◽  
Iliopsoas Muscle ◽  
Average Score ◽  
Iliopsoas Tendon ◽  
Snapping Hip ◽  
Endoscopic Release

Introduction: Internal snapping hip syndrome (ISHS) is caused by the iliopsoas tendon snapping over either the iliopectineal ridge or the anterior femoral head. Excellent results are achieved only with activity modification, rest, and stretching the iliopsoas muscle. The literature favors iliopsoas tendon release if conservative therapy fails. There is little evidence about the gold standard of this condition. Objective: Describe clinical results, complicactions and recurrence rate of arthroscopic treatment of ISHS. Methods: We included all patients who failed conservative treatment and were treated with arthroscopy for ISHS between March 2012 and March 2018. Patients with less than 2 years of follow up and previous surgery on the hip were excluded. We performed Ilizariturri´s technique with a transcapsular endoscopic release in central compartment. We registered modified Harris hip score (MHHS), Hip outcome score activity of daily living (EHOSDL), patients satisfaction, recurrence rate and complications. Results: Eight patients were included. Average follow up was 36 months (range 24-60 months). MMHS improved from preoperative average score of 70 (range 62-72) to postoperative average of 93 (range 92 to 96). Average EHOSDL improvement was 30% (from 55% preoperative to 85% postoperative). All patients had excellent results. Average patient satisfaction was 8 (range 7-9). We had no recurrence or complications. Conclusion: Arthroscopic treatment of ISHS allowed us to obtain very good clinical results with no complications or recurrences with a minimum 2 years follow up.

Mid-Term Results of Ceramic-on-Ceramic Total Hip Arthroplasty with Sandwich Cup

2006 ◽  
Vol 309-311 ◽  
pp. 1357-1362
Author(s):  
Masahiro Hasegawa ◽  
Akihiro Sudo ◽  
Atsumasa Uchida
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Clinical Results ◽  
Total Hip ◽  
The Mean ◽  
Acetabular Components ◽  
Mid Term Results ◽  
Ceramic On Ceramic

In ceramic-on-ceramic total hip arthroplasty (THA), modular acetabular component with a sandwich insertion was developed and evaluated mid-term clinical results. 35 hips had undergone cementless ceramic-on-ceramic THA with sandwich cup (Kyocera, Kyoto, Japan). The mean duration of follow-up was 5 years. 6 hips had undergone component revisions. The reasons for revision included infection in 1 hip, dislocation with loosening in 2 hips, alumina liner fractures in 2 hips, and cup dissociation in 1 hip. All femoral and acetabular components showed no loosening in the unrevised hips at the time of the last follow-up. None of the 29 unrevised hips had osteolysis.

Edge loading in third generation alumina ceramic-on-ceramic bearings

2004 ◽  
Vol 19 (4) ◽  
pp. 402-413 ◽  
Author(s):  
William L Walter ◽  
Gerard M Insley ◽  
William K Walter ◽  
Michael A Tuke
Keyword(s):  
Alumina Ceramic ◽  
Third Generation ◽  
Edge Loading ◽  
Ceramic On Ceramic
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