Outcome after Two Sequential Revision Hip Arthroplasties for CoC Bearing Fracture with 10 Years Follow-up: A Case Report

Introduction: Revisions due to the fracture of ceramic-on-ceramic (CoC) bearing are rare, however when they occur, they represent a major challenge to an orthopedic surgeon for ensuring safe and long-term survival of the replaced bearing. Case Report: We present a case of fractured ceramic liner of total hip prosthesis that underwent revision to a metal-on-polyethylene (MoP) bearing couple, with consequent huge periprosthetic metallosis. Shortly after, the second revision operation followed using the third bearing couple of ceramic-on-polyethylene (CoP). At 10 years follow-up after the operation due to ceramic fracture, the patient is now pain free with full range of motion of the revised hip. Conclusion: Establishment of diagnostic routes and recommended protocols for CoC bearing fracture would allow easier recognition of potential fracture and diminish its consequences for the patients. Keywords: Tribology, Revision Hip Arthroplasty, Ceramic Bearing Fracture.

COMPETITIVE LIFE TIME ASSESSMENT OF SrO-ZTA/SrO-ZTA AND CoCrMo/UHMWPE HIP PROSTHESIS BEARINGS

The hip joint envisages the prime load bearing structure among other joints in the human body. Hip joint failure leads to the replacement of the hip joint prosthesis. This research work focuses on the proper selection of bearing couple materials for the hip joint to improve the performance and life. Herein, the stress and deformation of different bearing couple materials are analysed in the perspective of transient dynamic analysis under jogging load cycle. Selective hip joint bearing (femoral head-liner) couples are SS316L on UHMWPE (MoP), CoCrMo on UHMWPE (MoP), Ti6Al4V on SrO-ZTA (MoC), SrO-ZTA on UHMWPE (CoP) and SrO-ZTA on SrO-ZTA (CoC) encountered, respectively. The SrO-ZTA on SrO-ZTA (CoC) bearing couple generates the less Von Mises stress of 180.88 MPa. Load bearing pressure and Archard law predict the wear depth of CoCrMo on UHMWPE (MoP) and SrO-ZTA on SrO-ZTA (CoC) bearing couples are 0.141 mm/year and 0.031 mm/year, respectively. In simultaneous, the theoretical wear volume for CoCrMo on UHMWPE (MoP) and SrO-ZTA on SrO-ZTA (CoC) bearing couples are found as 35.46[Formula: see text]mm3/year and 2.62[Formula: see text]mm3/year, respectively. The wear depth and wear volume are supporting the available clinical retrievals and exist in well acceptable range. Competitive wear analysis data ensures 15 years safe life of SrO-ZTA on SrO-ZTA (CoC) hip prosthesis bearing.

The Influence of Tribological Pairings and Other Factors on Migration Patterns of Short Stems in Total Hip Arthroplasty

Over the last decade, the number of short stem total hip arthroplasty procedures has increased. Along with the possible benefits associated with short stems is a smaller implant-bone contact surface, which may have a negative influence on primary stability and impair osseointegration. Previous studies observed migration of short stems, especially within the first three months. The variables that influence migration in short stem hip implants remain unknown. Therefore, the purpose of this study was to associate the migration of short stems with its possible influencing variables. Migration data from two different short stem studies were retrospectively analyzed. Migration within the first two postoperative years was determined by model-based Roentgen stereophotogrammetric analysis. Migration was correlated to bearing couple, type and size of stem, size of acetabular cup, and age, gender, weight, and height of patients using a multiple factor analysis. Eigenvalue analysis explained 80.7% of the overall variance for the first three dimensions. The four most dominant variables in the first dimension were weight, stem size, acetabular cup size, and patient height (correlations of 0.81, 0.80, 0.71, and 0.70, resp.). None of the analyzed parameters (bearing couple, type and size of stem, size of acetabular cup, and age, gender, weight, and height of patients) affected the migration pattern of short stem THA with primary metaphyseal fixation.