Delayed Fracture of a Ceramic Insert With Modern Ceramic Total Hip Replacement

Min, Byung-Woo; Song, Kyung‐Bin; Kang, Chang Goo; Bae, Ki-Cheol; Won, Ye Yeon; Lee, Kwon-Yong

doi:10.1016/j.arth.2005.12.012

Cited by 48 publications

(42 citation statements)

References 14 publications

(14 reference statements)

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“…Extensive metallosis was observed, compromising the bone bed due to both dissemination of hard ceramic fragments and direct wear of the metallic shell. In the Min et al 12 report, the degree of damage to the ceramic inlay, shown in Figure 5 of their paper, was mild in comparison to that observed in our study. Earlier surgery would undoubtedly have diminished metallosis.…”

Section: Discussioncontrasting

confidence: 52%

“…The fracture was probably caused by neck-rim 344 J. Gallo, T. Stewart, R. Novotny, J. Dusza, D. Galusek impingement due to extreme hip motions related to the daily activities of Asian people, who frequently squat or sit cross-legged. Evidence of contact between the femoral neck and acetabular rim was reported as a common feature on retrieved acetabular liners 12,13 . Although such extreme hip-joint motion is not likely in our case, stem-rim impingement cannot be completely excluded.…”

Section: Discussionmentioning

confidence: 99%

“…There is a previously reported case of fracture of a Plasma cup ceramic liner in a 34-year-old man (67 kg, 164 cm) from South Korea, 1 year and 9 months after surgery 12 . The fracture was probably caused by neck-rim 344 J. Gallo, T. Stewart, R. Novotny, J. Dusza, D. Galusek impingement due to extreme hip motions related to the daily activities of Asian people, who frequently squat or sit cross-legged.…”

Section: Discussionmentioning

confidence: 99%

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Early Fracture of a Plasma Cup Ceramic Liner: A Case Report and Surface Analysis

Gallo¹,

Stewart²,

Novotný³

et al. 2007

BIOMED PAP

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Early Fracture of a Plasma Cup Ceramic Liner: A Case Report and Surface Analysis

Gallo¹,

Stewart²,

Novotný³

et al. 2007

BIOMED PAP

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“…Although mechanistic information regarding fracture of ceramic liners is currently minimal, component impingement is believed to be a/the principal risk factor [14,17,23,28,36]. Component malpositioning [13], microseparation leading to edge loading [33], incomplete seating of modular liners [22], and obesity [30] have also been suggested.…”

Section: Introductionmentioning

confidence: 99%

Do Obesity and/or Stripe Wear Increase Ceramic Liner Fracture Risk? An XFEM Analysis

Elkins

Pedersen

Callaghan

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Hypothesized risk factors for fracture of ceramic liners include impingement, edge-loading, and cup malpositioning. These risk factors are similar to those for generation of stripe wear. However, it is unclear whether the biomechanical conditions contributing to stripe wear generation also increase the risk for ceramic liner fracture Questions/purposes We asked whether (1) head stripe wear propensity; and (2) cup orientation would correlate with alumina liner fracture risk for instances of normal and elevated body weight. Methods An eXtended Finite Element Method (XFEM) model was developed to investigate these mechanisms. Liner fracture risk for 36-mm alumina bearings was studied by simulating two fracture-prone motions: stooping and squatting. Twenty-five distinct cup orientations were considered with variants of both acetabular inclination and anteversion. Four separate body mass indices were considered: normal (25 kg/m 2 ) and three levels of obesity (33, 42, and 50 kg/ m 2 ). Material properties were modified to simulate alumina with and without the presence of dispersed microflaws. The model was validated by corroboration with two previously published ceramic liner fracture studies. Results Of 200 XFEM simulations with flaw-free alumina, fracture occurred in eight instances, all of them involving obesity. Each of these occurred with cups in B 37°inclina-tion and in 0°anteversion. For 200 corresponding simulations with microflawed alumina, fracture propensity was greatest for cups with higher (edge loading-associated) scraping wear. Fracture risk was greatest for cups with lower inclination (average 42°for fractured cases versus 48°for nonfractured cases) and lower anteversion (9°versus 20°). Conclusions Fracture propensity for 36-mm liners was elevated for cups with decreased anteversion and/or inclination and under conditions of patient obesity. Clinical Relevance Factors causing stripe wear, including obesity and cup malpositioning, also involve increased risk of ceramic liner fracture and merit heightened concern.

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“…Nonetheless, this complication is devastating and still occurs. (Min 2007) Even with proof testing, it is unlikely that failure by fracture will be eliminated. Although theoretically proof testing eliminates weaker components, flawed products that are likely to fail are not always eliminated.…”

Section: Ceramic Concernsmentioning

confidence: 99%

The Bearing Surfaces in Total Hip Arthroplasty – Options, Material Characteristics and Selection

Hosseinzadeh¹,

Eajazi²,

Shahi³

2012

Recent Advances in Arthroplasty

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Delayed Fracture of a Ceramic Insert With Modern Ceramic Total Hip Replacement

Cited by 48 publications

References 14 publications

Early Fracture of a Plasma Cup Ceramic Liner: A Case Report and Surface Analysis

Early Fracture of a Plasma Cup Ceramic Liner: A Case Report and Surface Analysis

Do Obesity and/or Stripe Wear Increase Ceramic Liner Fracture Risk? An XFEM Analysis

The Bearing Surfaces in Total Hip Arthroplasty – Options, Material Characteristics and Selection

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