Long-term results of uncemented alumina acetabular implants

Boehler, M.; Knahr, K.; Plenk, H.; Walter, A.; Salzer, M.; Schreiber, Verena

doi:10.1302/0301-620x.76b1.8300682

Cited by 137 publications

(58 citation statements)

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“…There are no unstable shells or pending failures in the ceramic group at 10 years. Alumina-ceramic bearings have a history of problems with neck/socket impingement, a potential for fracture, and aseptic loosening [2,16,21,30,37]. Considering survivorship revision for any reason, our ceramic cohorts had a survivorship of 95% and 98% and is similar to those of recent publications and may reflect improvements in implant design and the material properties of the ceramic [7,20].…”

Section: Discussionsupporting

confidence: 71%

Ceramic Bearings for Total Hip Arthroplasty Have High Survivorship at 10 Years

DʼAntonio

Capello

Naughton

2012

Clinical Orthopaedics &Amp; Related Research

109

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Background Ceramic bearings were introduced to reduce wear and increase long-term survivorship of total hip arthroplasty. In a previous study comparing ceramic with metal-on-polyethylene at 5 to 8 years, we found higher survivorship and no osteolysis for the ceramic bearings. Questions/Purposes We asked whether ceramic bearings have equal or superior survivorship compared with that for metal-on-polyethylene at longer followup; we also determined survivorship of the implant systems, the presence or absence of radiographic osteolysis, and incidence of device squeaking.Methods Five surgeons at five sites have followed 189 patients (216 hips) for a minimum of 10 years and average of 10.3 years (range, 10-12.4 years) comparing alumina ceramic bearings (144 hips) with cobalt chromeon-polyethylene bearings (72 hips). We determined KaplanMeier survivorship of the bearing surface and implant systems and collected radiographic and clinical data. Results We observed no difference between the control metal-on-polyethylene and the alumina-bearing couple cohorts with regard to bearing-related failures (98.9% versus 99.1%). Revisions for any reason occurred in 10

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Section: Discussionsupporting

confidence: 71%

Ceramic Bearings for Total Hip Arthroplasty Have High Survivorship at 10 Years

DʼAntonio

Capello

Naughton

2012

Clinical Orthopaedics &Amp; Related Research

109

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“…To reduce wear, Boutin [7] reported the use of alumina-on-alumina bearing surfaces in total hip arthroplasty (THA) in 1972. There have been many subsequent reports [3,4,9,12,18,19,25,31,32] regarding the use of ceramic total hip systems. In principle ceramics have the potential for low rates of wear compared to metal-on-polyethylene, and in one study alumina-ceramic bearings demonstrated the lowest rates of in vivo wear as compared with metal -polyethylene combination [20].…”

Section: Introductionmentioning

confidence: 99%

Ceramic-Ceramic Bearing Decreases Osteolysis: A 20-year Study versus Ceramic-Polyethylene on the Contralateral Hip

Hernigou

Zilber

Filippini

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Although ceramic implants have been in use for many years and they are intended to minimize wear debris it is unknown whether alumina-on-alumina or alumina-onpolyethylene produce less wear and osteolysis. We therefore investigated wear and osteolysis on 28 bilateral arthroplasties (one ceramic-ceramic and the contralateral ceramic-polyethylene) of patients who had survived 20 years without revision and without loosening of either hip. Osteolysis was identified on anteroposterior pelvic radiographs and 3-D volume from CT scans. The number of osteolytic lesions detected with CT scan was higher than with radiographs. The number of lesions was higher on the side with the alumina-PE couple. With a similar length of followup on each side, the surface and the volume of osteolysis were consistently higher on the side with the alumina-PE couple. We found no correlation between the volume of osteolysis and the volume of estimated wear in each couple of friction. Hips with osteolysis had a lower Harris score.

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“…[15][16][17][18][19][20][21][22][23] Light-microscope studies of membranes around revised ceramic THRs reported sizes of alumina particle of between 1 and 3 m which is similar to the grain size of alumina used for production. 15,24,25 Since a size of 1 m is at the lower limit for light microscopy, more sensitive methods have been developed to evaluate submicron debris in tissue membranes. …”

mentioning

confidence: 99%

Wear debris from two different alumina-on-alumina total hip arthroplasties

Böhler

Mochida

Bauer

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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W e compared wear particles from two different designs of total hip arthroplasty with polycrystalline alumina-ceramic bearings of different production periods (group 1, before ISO 6474: group 2, according to ISO 6474). The neocapsules and interfacial connective tissue membranes were retrieved after mean implantation times of 131 months and 38 months, respectively. Specimen blocks were freed from embedding media, either methylmethacrylate or paraffin and digested in concentrated nitric acid. Particles were then counted and their sizes and composition determined by SEM and energy-dispersive x-ray analysis (EDXA).The mean numbers and sizes of most alumina wear particles did not differ for both production periods, but the larger sizes of particle in group 1 point to more severe surface destruction. The increased metal wear in group 2 was apparently due to alumina-induced abrasion of the stems. In this study the concentrations of particles in the periprosthetic tissues were 2 to 22 times lower than those observed previously with polyethylene and alumina/polyethylene wear couples. [Br] 2000;82-B:901-9. J Bone Joint Surg Received 11 December 1998; Accepted after revision 20 September 1999The size, shape and composition of wear particles play a central role in the development of aseptic loosening and osteolysis in total hip replacement (THR). [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Various studies have shown the good performance of the alumina ceramic-on-ceramic articular surfaces in terms of frictional behaviour, low annual rates of wear and relatively low reactivity of debris in the periprosthetic tissues, compared with polyethylene wear from metal-polyethylene couples. [15][16][17][18][19][20][21][22][23] Light-microscope studies of membranes around revised ceramic THRs reported sizes of alumina particle of between 1 and 3 m which is similar to the grain size of alumina used for production. 15,24,25 Since a size of 1 m is at the lower limit for light microscopy, more sensitive methods have been developed to evaluate submicron debris in tissue membranes. 26-28The purpose of the present study was to describe the histology of periarticular tissues around failed alumina ceramic-on-ceramic total hip prostheses and to compare the tissue concentration and physical characteristics of isolated wear particles originating from two types of Al 2 O 3 ceramic used for these THRs: 1) a series of cementless, monolithic ceramic cups with ceramic heads, produced after 1975 but before the ISO 6474; and 2) more recently manufactured ceramic inserts for a commercially pure (cp) Ti-backed acetabular cup and ceramic ball head (BIOLOX, according to ISO 6474; Ceramtec, Plochingen, Germany) with a Tialloy stem. We have compared our findings with the results from previously published studies which used identical techniques of isolation and characterisation of wear particles to analyse tissues adjacent to failed cemented and uncemented metal-polyethylene total hip prostheses. [26][27][28] Materials and Methods (Table I) Group 1. Betwee...

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Long-term results of uncemented alumina acetabular implants

Cited by 137 publications

References 0 publications

Ceramic Bearings for Total Hip Arthroplasty Have High Survivorship at 10 Years

Ceramic Bearings for Total Hip Arthroplasty Have High Survivorship at 10 Years

Ceramic-Ceramic Bearing Decreases Osteolysis: A 20-year Study versus Ceramic-Polyethylene on the Contralateral Hip

Wear debris from two different alumina-on-alumina total hip arthroplasties

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