Revision of Ceramic Head Fracture After Third Generation Ceramic-on-Ceramic Total Hip Arthroplasty

Koo, Kyung‐Hoi; Ha, Yong‐Chan; Kim, Shin‐Yoon; Yoon, Kang Sup; Min, Byung Woo; Kim, Sang Rim

doi:10.1016/j.arth.2013.04.007

Cited by 39 publications

(29 citation statements)

References 12 publications

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“…A serious complication with ceramic implants is fracture, which may lead to reoperation and to a poor prognosis. One study showed that at a mean follow-up of 5 years after revision due to ceramic head fracture in 24 patients with BIOLOX forte ceramic bearings, 5 patients needed a second revision and 2 of them underwent a third revision ( Koo et al 2014 ). The reported incidence of ceramic component fracture varies from 0.01% to 3.5% ( Ha et al 2007 , D’Antonio and Sutton 2009 , Traina et al 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the risk of revision in cementless total hip arthroplasty with ceramic-on-ceramic and metal-on-polyethylene bearings

Varnum¹,

Pedersen²,

Kjærsgaard‐Andersen³

et al. 2015

Acta Orthopaedica

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Background and purpose Ceramic-on-ceramic (CoC) bearings were introduced in total hip arthroplasty (THA) to reduce problems related to polyethylene wear. We compared the 9-year revision risk for cementless CoC THA and for cementless metal-on-polyethylene (MoP) THA.Patients and methods In this prospective, population-based study from the Danish Hip Arthroplasty Registry, we identified all the primary cementless THAs that had been performed from 2002 through 2009 (n = 25,656). Of these, 1,773 THAs with CoC bearings and 9,323 THAs with MoP bearings were included in the study. To estimate the relative risk (RR) of revision, we used regression with the pseudo-value approach and treated death as a competing risk.Results 444 revisions were identified: 4.0% for CoC THA (71 of 1,773) and 4.0% for MoP THA (373 of 9,323). No statistically significant difference in the risk of revision for any reason was found for CoC and MoP bearings after 9 years of follow-up (adjusted RR = 1.3, 95% CI: 0.72–2.4). Revision rates due to component failure were 0.5% (n = 8) for CoC bearings and 0.1% (n = 6) for MoP bearings (p < 0.001). 6 patients with CoC bearings (0.34%) underwent revision due to ceramic fracture.Interpretation When compared to the “standard” MoP bearings, CoC THA had a 33% higher (though not statistically significantly higher) risk of revision for any reason at 9 years.

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Section: Discussionmentioning

confidence: 99%

Comparison of the risk of revision in cementless total hip arthroplasty with ceramic-on-ceramic and metal-on-polyethylene bearings

Varnum¹,

Pedersen²,

Kjærsgaard‐Andersen³

et al. 2015

Acta Orthopaedica

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“…28,29 However, although uncommon, fracture of ceramic heads is still a concern as it results in a catastrophic complication. 30,31 Future long-term follow-up studies are needed to determine implant survivorship in tall-statured patients with large diameter acetabular cups and femoral heads. This study is not without limitations.…”

Section: Discussionmentioning

confidence: 99%

Tall-Statured Patients Have Similar Outcomes to Normal Height Patients after Primary Total Hip Arthroplasty

Warren

Groover

Santana

et al. 2020

The Journal of Hip Surgery

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Total hip arthroplasty (THA) has been proven to be a safe and efficacious operation; however, there is a paucity of literature on outcomes in patients in the 99th percentile for height. The objectives of this study were to identify differences in (1) implant selection, (2) operative times, (3) intraoperative and postoperative complications, (4) 90-day readmission, (5) all cause reoperation rates, and (6) hospital length of stay (LOS), in tall-statured patients compared with a matched control cohort. An electronic research request was used to identify 12,850 patients who underwent THA from January 2012 to December 2016 with minimum 1-year follow-up at a single health care system for retrospective chart review. Patients were identified in the 99th percentile for height (193 cm for males and 177 cm for females) and then matched to controls based on gender, race, age, body mass index, and Charlson comorbidity index. A total of 260 THA patients (2%) were identified in the 99th percentile for height. The tall-statured patients were then matched to 248 patients of normal stature. The exclusion criteria was met by 172 tall-statured patients and 165 normal-statured patients. Final analysis comprised of 86 tall-statured patients (100 THA) and 83 matched normal-statured patients (92 THA). Baseline demographics information and the outcomes of interest were then compared. The mean height of the female patients in the tall cohort was 181.01 ± 2.51 cm compared with 166.6 ± 6.98 cm for the control group (p < 0.001), while it was 195.25 ± 4.03 cm for male patients in the tall cohort and 174.11 ± 4.63 cm for the control cohort (p < 0.001). Tall-statured patients had larger acetabular cups (p < 0.001) and femoral head (p = 0.046) components. There were no differences in reoperation (p = 0.282), 90-day readmissions (p = 0.862), intraoperative fractures (p = 0.228), postoperative complications (p = 0.678), operative times (p = 0.890), and LOS (p = 0.099) between the tall-statured and normal-statured patients. Patients that are in the 99th percentile for height have similar outcomes to patients that are of normal height. The level of evidence of this study is level 3.

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“…Der Erhalt der Schaftkomponente ist in diesen Fällen auch abhängig vom Erhalt des Konus. Von der Anwendung eines neuen Keramikkopfes bei gebrauchtem Konus ist dringend abzuraten, da minimale Veränderungen des Konus zu einem erhöhten Bruchrisiko des Keramikkopfes führen können [26]. Eine Option sind Keramikköpfe mit Titanadapterhülse, die einen unnötigen Wechsel eines festsitzenden Femurschafts verhindern, wodurch die Operationszeit verkürzt und mögliche perioperative Komplikationen reduziert werden können [15, 48 -50].…”

Section: Conclusion Modern Coc Bearings Show Advantages In Pre-unclassified

“…Eine Option sind Keramikköpfe mit Titanadapterhülse, die einen unnötigen Wechsel eines festsitzenden Femurschafts verhindern, wodurch die Operationszeit verkürzt und mögliche perioperative Komplikationen reduziert werden können [15, 48 -50]. Dabei ist aber die genaue Inspektion des Konus mit haptisch-manueller Prüfung der Oberfläche entscheidend, da nur bei fehlender Konusschädigung ein Titanadapter angewendet werden darf [26,30,51]. Zusätzlich bieten manche Hersteller bereits Instrumente zur intraoperativen Überprüfung der Konusgeometrie an.…”

Section: Conclusion Modern Coc Bearings Show Advantages In Pre-unclassified

Ceramic-on-Ceramic in Total Hip Replacement Revision

Cucchi

Gathen

Streicher³

et al. 2018

Z Orthop Unfall

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Modern CoC bearings show advantages in preclinical and retrospective studies over other bearings also in revision cases and are therefore to be considered a promising alternative for this kind of operation. Reasonable indications for CoC bearing in revision THA are revisions for aseptic loosening or recurrent dislocation in young patients, fractures of ceramic components, large acetabular defects or in patients that are allergic to bone cement components. Nevertheless, prospectively designed or randomized studies are lacking and needed to confirm CoC as optimal solution for revision THA cases.

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Revision of Ceramic Head Fracture After Third Generation Ceramic-on-Ceramic Total Hip Arthroplasty

Cited by 39 publications

References 12 publications

Comparison of the risk of revision in cementless total hip arthroplasty with ceramic-on-ceramic and metal-on-polyethylene bearings

Comparison of the risk of revision in cementless total hip arthroplasty with ceramic-on-ceramic and metal-on-polyethylene bearings

Tall-Statured Patients Have Similar Outcomes to Normal Height Patients after Primary Total Hip Arthroplasty

Ceramic-on-Ceramic in Total Hip Replacement Revision

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