Influence of various types of damage on the fracture strength of ceramic femoral heads

Wuttke, Viola; Witte, Hartmut; Kempf, Katrin; Oberbach, Thomas; Delfosse, Daniel

doi:10.1515/bmt.2011.026

Cited by 17 publications

(17 citation statements)

References 24 publications

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“…Contrary to previous studies [12,23,24], in the present study all damage was caused by actual (in-vitro) head failure and not artificial manipulation of the taper surface (except for cleaning after each fracture test). The shape and number of the ceramic fragments from the low fracture loads matches well with reported in-vivo fractures [10,11,[28][29][30] indicating that the test design reproduced clinical damage of male tapers.…”

Section: Discussioncontrasting

confidence: 85%

“…The influence of various contaminants or artificially introduced damage of the taper surface on the fracture strength of ceramic heads has been widely investigated. High correlations between damage and reduced fracture strength have been reported [12,23,24]. The aim of this study was to determine the in-vitro fracture load of new ceramic heads paired with re-used tapers that have been subject to prior head fracture and to evaluate related surface damage.…”

Section: Introductionmentioning

confidence: 99%

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The influence of stem taper re-use upon the failure load of ceramic heads

Gührs

Krull

Witt

et al. 2015

Medical Engineering & Physics

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Section: Discussioncontrasting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

The influence of stem taper re-use upon the failure load of ceramic heads

Gührs

Krull

Witt

et al. 2015

Medical Engineering & Physics

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“…Only 17% of all patients with a ceramic ball head needed a second revision procedure [ 9 ]. On the basis of mechanical tests [ 8 ] and case reports [ 4 ], it is known that even small damage to or contamination of the stem taper decreases the fracture strength of the ceramic head. In addition, a mismatch between the taper and head may lead to accelerated wear and therefore the need for an earlier revision [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that a precise match of the taper and the femoral head is crucial to avoid stress in localized areas of the ceramic head [ 4 – 8 ]. It is generally not recommended to use a ceramic head on an existing taper during revision surgery, because undetected damage in the taper may increase the risk of ceramic fracture [ 4 , 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Two-year follow-up of revision total hip arthroplasty using a ceramic revision head with a retained well-fixed femoral component: a case series

2014

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IntroductionIt is known that a well-fixed stem can be left in situ when only the acetabular component and femoral head have to be changed. However, in a revision case, the use of a ceramic head on an existing taper is not recommended. Slight damages of the taper may increase the risk of a ceramic fracture. Until now in a revision case a primary ceramic-on-ceramic or ceramic-on-polyethylene pairing was changed to a metal-on-polyethylene pairing or the well-fixed stem was removed as well. During the past several years, a ceramic head with a metallic sleeve has been introduced as an option for revisions with a stem left in situ. We report short-term results of a ceramic revision head in this clinical setting.MethodsEight patients with a ceramic revision head were clinically and radiologically followed up two years after revision surgery. Their Harris Hip Score and visual analogue scale scores for pain and satisfaction were recorded, and their radiographs were checked for osteolysis and heterotopic ossifications.ResultsThe mean Harris Hip Score increased from 46.5 points before surgery to 88.3 points 2 years after surgery. The mean visual analogue scale score for pain improved from 6.7 to 1.1, and the mean visual analogue scale for satisfaction rose from 5.1 to 8.3. The radiological results did not show osteolysis in any of the patients. Grade I heterotopic ossification according to the Brooker classification system was seen in one patient.ConclusionsThe early clinical and radiological results in this case series are in agreement with previously published studies. Ceramic revision heads with a metallic sleeve are a promising approach in the revision of a ceramic head with a well-fixed stem which can be left in situ. This solution avoids an unnecessary exchange of a well-fixed stem and thereby shortens the surgical time of the revision and may reduce the peri-operative complications.

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“…Tapers are designed for clean and dry assembly conditions. Assembling them in a contaminated situation (blood, bone, water, fat) causes an increase in micro-motion during loading or a reduction in fracture strength of ceramic heads [26,32,37,45,53]. This is the reason why stem tapers should always be carefully cleaned, rinsed, and dried before assembly.…”

Section: Assemblymentioning

confidence: 99%

Corrosion of the Head-Stem Taper Junction—Are We on the Verge of an Epidemic?

Morlock

Bünte

Gührs

et al. 2017

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: The modular head taper junction has contributed to the success of total hip arthroplasty (THA) greatly. Taper corrosion and wear problems reported for large and extralarge metal-on-metal bearings as well as for bi-modular THA stems have cast doubt on the benefit of the taper interface. Presently, corrosion problems are being reported for nearly all kinds of artificial hip joints incorporating metal heads, questioning taper connections in general. Questions/purposes: This study aimed to review the mechanical and electrochemical relationships that may lead to taper corrosion, which have been reported more commonly in recent literature, and to also review the contribution of patient characteristics and surgical techniques involved in taper assembly that may contribute to the problem. Methods: The search criteria B(corrosion) AND (hip arthroplasty) AND (taper OR trunnion)^and B(hip arthroplasty) AND ((pseudotumor) OR (pseudo-tumor))^in PubMed and the JAAOS were used for the literature search. In addition, the arthroplasty registers were considered. Results: Most studies acknowledge the multifactorial nature of the problem but concentrate their analysis on taper and implant design aspects, since this is the only factor that can be easily quantified. The sometimes conflicting results in the literature could be due to the fact that the other two decisive factors are not sufficiently considered: the loading situation in the patient and the assembly situation by the surgeon. All three factors together determine the fate of a taper junction in THA. There is no single reason as a main cause for taper corrosion. The combined Boutcome^of these three factors has to be in a Bsafe range^to achieve a successful longterm taper fixation. Conclusion: No, this is not the beginning of an epidemic. It is rather the consequence of disregarding known mechanical and electrochemical relationships, which in combination have recently caused a more frequent occurrence-and mainly reporting-of corrosion issues.

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Influence of various types of damage on the fracture strength of ceramic femoral heads

Cited by 17 publications

References 24 publications

The influence of stem taper re-use upon the failure load of ceramic heads

The influence of stem taper re-use upon the failure load of ceramic heads

Two-year follow-up of revision total hip arthroplasty using a ceramic revision head with a retained well-fixed femoral component: a case series

Corrosion of the Head-Stem Taper Junction—Are We on the Verge of an Epidemic?

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