Potential risk of AMC ceramic liner for dissociation after square seating

Baek, Seung‐Hoon; Kim, Jun Young; Han, Jung Won; Kim, Shin‐Yoon

doi:10.1016/j.jos.2016.07.004

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…Various hypotheses exist in the literature regarding the etiology of ceramic liner dissociation, including failure to impact the liner with sufficient force [ 3 ], interposition of soft tissue or bone fragments [ 3 ], deformation of the metal shell [ 1 ], excessive rotational torque to the liner owing to wear-roughened joint surfaces [ 17 ]. The cause of the dissociation in the present case was unclear.…”

Section: Discussionmentioning

confidence: 99%

“…There have been few reports of dissociation with AMC prostheses and that all of these have been treated with revision surgery due to concerns of fragmentation. Six AMC ceramic liner dissociation cases in 1103 hips have been reported, all of which were promptly revised on diagnosis [3][4][5][6]. In three of these six cases, dissociations were found immediately after surgery, and one just before suturing [3,6].…”

Section: Discussionmentioning

confidence: 99%

“…Six AMC ceramic liner dissociation cases in 1103 hips have been reported, all of which were promptly revised on diagnosis [3][4][5][6]. In three of these six cases, dissociations were found immediately after surgery, and one just before suturing [3,6]. The other two AMC liner dissociations were detected after liner fracture, presumed to be a consequence of dissociation [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…However, there are still complications for ceramic-on-ceramic hip prostheses, one of which is ceramic liner dissociation. All AMC liner dissociation cases in the literature were immediately rectified with revision due to concerns about adverse outcomes, such as fragmentation [3][4][5][6]. To the best of our knowledge, there are no report of dissociation with spontaneous resolution…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous resolution of asymptomatic alumina matrix composite ceramic liner dissociation: a case report

Wang

Zheng

et al. 2022

BMC Musculoskelet Disord

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Background Total hip arthroplasty(THA)is widely used to treat end-stage hip disorders. Ceramic-on-ceramic total hip prostheses are widely used because of their durability. Alumina matrix composite (AMC), known as the fourth-generation ceramics, reduces implant fracture and wear rate compared to their predecessors. However, ceramic acetabular liner dissociation is a complication that necessitates revision of the AMC prostheses. To date, only few cases of AMC liner dissociation have been reported and all of which have been treated with revision surgery. Therefore, the prognosis of non-operated AMC liner dissociation remains unknown so far. Case presentation A 57-year-old man with avascular necrosis of the femoral head was treated with THA, wherein a Pinnacle® (DePuy, J&J, Warsaw, IN) acetabular cup and AMC liner were implanted. Intraoperative examination confirmed proper seating of the liner, whereas the initial postoperative radiograph revealed liner dissociation. The patient refused surgical revision due to the absence of symptoms and was discharged and followed-up. The patient made an uneventful recovery, and radiographic follow-up at 6-month post-operation showed that the liner was re-seated to its right position. No clinical or radiographic anomaly was found at the 15-month of postoperative follow-up. Conclusions Here, we report an unprecedented case of AMC ceramic liner dissociation with spontaneous resolution. This case shows that ceramic liner dissociation could be asymptomatic, and careful postoperative examination of the patient is important. Spontaneous resolution is possible, but the underlying mechanism and the eligible patient to benefit from it must be investigated. Before clarifying these questions, revision surgery should be the first-line treatment.

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