Delayed Diagnosis of Low-Symptomatic Ceramic Acetabular Liner Fracture in Ceramic-on-Ceramic Total Hip Arthroplasty

Regis, Dario; Sandri, Andrea; Bartolozzi, Pietro

doi:10.3928/01477447-20110525-23

Cited by 15 publications

(11 citation statements)

References 19 publications

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“…Many improvements have been made and biomechanical and tribological properties of alumina ceramics are now better known. The third generation of ceramic alumina is currently in use [4,5], and the risk of fracture is now extremely rare [6]. In addition, wear seems to be undetectable.…”

Section: Introductionmentioning

confidence: 99%

Nine years follow-up of 100 ceramic-on-ceramic total hip arthroplasty

Chevillotte

Pibarot

Carret

et al. 2010

International Orthopaedics (SICOT)

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The aim of this study was to evaluate the first 100 cementless ceramic-on-ceramic total hip arthroplasty (THA) performed at our institution with more than nine years of follow-up. Clinical evaluation was performed using Harris hip score. Radiological evaluation was performed by two surgeons. Four patients were lost to follow-up. Harris hip score significantly improved at latest follow-up. Radiological analysis showed calcar osteolysis for 75 patients and one cup loosening. One patient required a revision five years postoperatively for cup loosening. Based on these results and the routine use of a navigation system to optimise positioning of the implants, we advocate the use of uncemented hydroxyapatite coated ceramic-onceramic THA in young and active patients in our current practice.

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Section: Introductionmentioning

confidence: 99%

Nine years follow-up of 100 ceramic-on-ceramic total hip arthroplasty

Chevillotte

Pibarot

Carret

et al. 2010

International Orthopaedics (SICOT)

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“…In addition, a ceramic chip may have occurred upon insertion of the total hip arthroplasty, resulting in a roughened surface that may have become progressively worn. Poor ceramic material may contribute to wear,9 even though ceramic manufacturing is extremely rigorous and usually includes isostatic pressing, laser and thermal etching and hydraulic press testing of all implants 11…”

Section: Discussionmentioning

confidence: 99%

Catastrophic failure of ceramic-on-ceramic total hip arthroplasty presenting as squeaking hip

et al. 2013

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A 68-year-old woman with osteoarthritis had a ceramic-on-ceramic left total hip arthroplasty, including ceramic femoral head and acetabular liner. At 5 years after surgery, the patient developed onset of a very loud squeaking noise, which could be heard 25 m from her, associated with limited hip movement. Findings at revision surgery included a broken ceramic femoral head component, complete wear of the ceramic acetabular component, and black wear debris. Squeaking hip after ceramic-on-ceramic total hip arthroplasty may be associated with catastrophic failure of the arthroplasty components.

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“…13 An excess load during flexion movements (eg, rising from a chair or climbing a steep staircase) is considered to be a possible mechanism of dislocation. 14,15 Other mechanisms are related to surgical planning and procedures, such as malposition of the cup, stem, or both. 16,17 In the current case, the authors believe that muscle loss associated with acetabular cup retroversion encouraged an impingement between the femoroacetabular modular neck and ceramic liner.…”

Section: Discussionmentioning

confidence: 99%

Ceramic Liner Fatigue Fracture: 3-D CT Findings in a Late Recurrent THA Dislocation

Trivellin¹,

Sandri²,

Bizzotto³

et al. 2013

Orthopedics

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Dislocation is one of the most common complications of total hip arthroplasty (THA). To the authors' knowledge, late recurrent dislocation of a THA with a ceramic-on-ceramic coupling secondary to fatigue fracture of the ceramic liner has never been described. A 76-year-old woman with right hip osteoarthritis underwent cementless modular THA with a ceramic-on-ceramic coupling. Approximately 10 years postoperatively, she experienced right hip pain with no trauma, which resolved in 14 days. Family members reported that the patient had shown a progressive cognitive and muscular decline in the previous months. Six months later, the patient was admitted for THA dislocation, which was immediately reduced. Computed tomography revealed that the right acetabular component had a retroversion of 4° and an inclination angle of 45°. An orthopedic brace was applied, but dislocation recurred 2 days after discharge. A 3-dimensional CT reconstruction showed a fracture of the ceramic liner in the posterolateral region. The patient underwent revision surgery, and the ceramic liner breakage was confirmed. After removal of the acetabular components, a cemented polyethylene cup was implanted. The stability of the stem was verified. The existing modular neck was replaced with a chromium-cobalt neck, and a new ceramic head was applied. At 7-month follow-up, the patient had good functional recovery with no hip instability. Fatigue failure of a ceramic liner should be considered as responsible for late dislocation after ceramic-on-ceramic THA. As part of the diagnostic strategy, 3-dimensional CT reconstruction should be used to evaluate ceramic liner breakage.

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Delayed Diagnosis of Low-Symptomatic Ceramic Acetabular Liner Fracture in Ceramic-on-Ceramic Total Hip Arthroplasty

Cited by 15 publications

References 19 publications

Nine years follow-up of 100 ceramic-on-ceramic total hip arthroplasty

Nine years follow-up of 100 ceramic-on-ceramic total hip arthroplasty

Catastrophic failure of ceramic-on-ceramic total hip arthroplasty presenting as squeaking hip

Ceramic Liner Fatigue Fracture: 3-D CT Findings in a Late Recurrent THA Dislocation

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