Early Dislocation Rate in Ceramic-on-Ceramic Total Hip Arthroplasty

Abstract

Wear debris from metal-on-polyethylene articulation in conventional total hip arthroplasty (THA) may limit THA longevity. Bearing surfaces made of modern ceramic material, with high wear resistance and low fracture risk, have the potential to extend the longevity of THA and make the procedure more suitable for young, active patients. Concerns regarding a ceramic-on-ceramic bearing surface have included potential for a higher incidence of dislocation caused by limited modular neck length and liner options. This prospective study assessed the early dislocation incidence for a ceramic-on-ceramic THA system. Out of the 336 consecutive ceramic-on-ceramic THA performed at our institution over an 8-year (1997-2005) period, 2 (0.6%) sustained dislocation during, and none after, the first postoperative year. Both dislocations were treated with closed reduction. No component fracture or revision for any reason has occurred in this series.

Clinical and Radiological Outcome of the Newest Generation of Ceramic-on-Ceramic Hip Arthroplasty in Young Patients

“…Recognition of squeaking in ceramic articulations as a clinical problem has increased recently [16,17,31] with its incidence ranging from 0.48% to 7% [11,18,32]. Squeaking has been shown to be due to ceramic or metal wear, component factors, implant design, impingement, implant positioning [11,18], and patient characteristics [27]. Squeaking often occurs in younger, heavier, and taller patients [33].…”

“…These enhanced mechanical properties should decrease the ceramic fracture rate, allowing the manufacturing of thinner acetabular liner inserts and therefore the use of larger femoral head options. This increased head size should improve joint stability and reduce dislocation rates [18,19]. One study also suggests that material properties of the AMC may lead to a different wear response and may decrease or eliminate squeaking [17].…”

Ceramic-on-ceramic bearing surface and risk of revision due to dislocation after primary total hip replacement

“…[27][28][29] Concerns of a higher dislocation rate due to limited availability of options for neck length and the liner have been noted, but no study has demonstrated a higher dislocation rate or revision due to dislocation with these bearing surfaces. [30][31][32] One review looked at the differences in forces required to dislocate THRs in vitro. 33 No difference was found in stability between different bearing surfaces where the components were implanted in the optimal position.…”

Robot‐assisted total hip arthroplasty: Clinical outcomes and complication rate

“…In another study that reviewed 336 ceramic‐on‐ceramic THAs, Mai et al . demonstrated an early dislocation rate of 0.6% . In a multi‐centre study by Barnett et al .…”