Fracture of Ceramic Bearing Surfaces Following Total Hip Replacement: a Systematic Review

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2013 Jul 12

PMID 23844356

Citations 44

Authors

Francesco Traina

Marcello De Fine

Alberto Di Martino

Cesare Faldini

Affiliations

Soon will be listed here.

Abstract

Ceramic bearing surfaces are increasingly used for total hip replacement, notwithstanding that concern is still related to ceramic brittleness and its possible mechanical failure. The aim of this systematic review is to answer three questions: (1) Are there risk factors for ceramic component fracture following total hip replacement? (2) Is it possible to perform an early diagnosis of ceramic component failure before catastrophic fracture occurs? (3) Is it possible to draw guidelines for revision surgery after ceramic components failure? A PubMed and Google Scholar search was performed and reference citations from publications identified in the literature search were reviewed. The use of 28 mm short-neck femoral head carries an increased risk of fracture. Acetabular component malposition might increase the risk of ceramic liner fractures. Synovial fluid microanalysis and CT scan are promising in early diagnosis of ceramic head and liner failure. Early revision is suggested in case of component failure; no consensus exists about the better coupling for revision surgery. Ceramic brittleness remains a major concern. Due to the increased number of ceramic on ceramic implants, more revision surgeries and reports on ceramic components failure are expected in the future. An algorithm of diagnosis and treatment for ceramic hip failure is proposed.

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References

Habermann B, Ewald W, Rauschmann M, Zichner L, Kurth A . Fracture of ceramic heads in total hip replacement. Arch Orthop Trauma Surg. 2006; 126(7):464-70. DOI: 10.1007/s00402-006-0173-y. View

Dunstan E, Ladon D, Whittingham-Jones P, Carrington R, Briggs T . Chromosomal aberrations in the peripheral blood of patients with metal-on-metal hip bearings. J Bone Joint Surg Am. 2008; 90(3):517-22. DOI: 10.2106/JBJS.F.01435. View

Koo K, Ha Y, Jung W, Kim S, Yoo J, Kim H . Isolated fracture of the ceramic head after third-generation alumina-on-alumina total hip arthroplasty. J Bone Joint Surg Am. 2008; 90(2):329-36. DOI: 10.2106/JBJS.F.01489. View

Nizard R, Sedel L, Christel P, Meunier A, Soudry M, Witvoet J . Ten-year survivorship of cemented ceramic-ceramic total hip prosthesis. Clin Orthop Relat Res. 1992; (282):53-63. View

Yoo J, Kim Y, Yoon K, Koo K, Song W, Kim H . Alumina-on-alumina total hip arthroplasty. A five-year minimum follow-up study. J Bone Joint Surg Am. 2005; 87(3):530-5. DOI: 10.2106/JBJS.D.01753. View

Hwang D, Kim Y, Lee C . Alumina femoral head fracture in uncemented total hip arthroplasty with a ceramic sandwich cup. J Arthroplasty. 2007; 22(3):468-71. DOI: 10.1016/j.arth.2006.05.020. View

Christel P . Biocompatibility of surgical-grade dense polycrystalline alumina. Clin Orthop Relat Res. 1992; (282):10-8. View

Higuchi F, Shiba N, Inoue A, Wakebe I . Fracture of an alumina ceramic head in total hip arthroplasty. J Arthroplasty. 1995; 10(6):851-4. DOI: 10.1016/s0883-5403(05)80086-5. View

Maccauro G, Piconi C, Burger W, Pilloni L, De Santis E, Muratori F . Fracture of a Y-TZP ceramic femoral head. Analysis of a fault. J Bone Joint Surg Br. 2004; 86(8):1192-6. DOI: 10.1302/0301-620x.86b8.15012. View

10.

Krol R, Wiatrak A, Kaminski A . Management of fractures of ceramic heads in total hip arthroplasty patients. Ortop Traumatol Rehabil. 2007; 9(4):429-35. View

11.

Visuri T, Pukkala E, Paavolainen P, Pulkkinen P, RISKA E . Cancer risk after metal on metal and polyethylene on metal total hip arthroplasty. Clin Orthop Relat Res. 1996; (329 Suppl):S280-9. DOI: 10.1097/00003086-199608001-00025. View

12.

Gudena R, Kuna S, Pradhan N . Aseptic loosening of total hip replacement presenting as an anterior thigh mass. Musculoskelet Surg. 2011; 97(3):247-9. DOI: 10.1007/s12306-011-0167-y. View

13.

Popescu D, Gallart X, Garcia S, Bori G, Tomas X, Riba J . Fracture of a ceramic liner in a total hip arthroplasty with a sandwich cup. Arch Orthop Trauma Surg. 2007; 128(8):783-5. DOI: 10.1007/s00402-007-0536-z. View

14.

Toni A, Terzi S, Sudanese A, Zappoli F, Giunti A . Fracture of the ceramic epiphysis in hip arthroplasty. Chir Organi Mov. 1996; 81(1):11-9. View

15.

Faldini C, Miscione M, Chehrassan M, Acri F, Pungetti C, dAmato M . Congenital hip dysplasia treated by total hip arthroplasty using cementless tapered stem in patients younger than 50 years old: results after 12-years follow-up. J Orthop Traumatol. 2011; 12(4):213-8. PMC: 3225629. DOI: 10.1007/s10195-011-0170-y. View

16.

Masonis J, Bourne R, Ries M, McCalden R, Salehi A, Kelman D . Zirconia femoral head fractures: a clinical and retrieval analysis. J Arthroplasty. 2004; 19(7):898-905. DOI: 10.1016/j.arth.2004.02.045. View

17.

Sariali E, Stewart T, Mamoudy P, Jin Z, Fisher J . Undetected fracture of an alumina ceramic on ceramic hip prosthesis. J Arthroplasty. 2009; 25(4):658.e1-5. DOI: 10.1016/j.arth.2009.05.013. View

18.

Park Y, Hwang S, Choy W, Kim Y, Moon Y, Lim S . Ceramic failure after total hip arthroplasty with an alumina-on-alumina bearing. J Bone Joint Surg Am. 2006; 88(4):780-7. DOI: 10.2106/JBJS.E.00618. View

19.

Choi I, Kim Y, Hwang K, Kim Y . Incidence and factors associated with squeaking in alumina-on-alumina THA. Clin Orthop Relat Res. 2010; 468(12):3234-9. PMC: 2974873. DOI: 10.1007/s11999-010-1394-5. View

20.

Sharma V, Ranawat A, Rasquinha V, Weiskopf J, Howard H, Ranawat C . Revision total hip arthroplasty for ceramic head fracture: a long-term follow-up. J Arthroplasty. 2010; 25(3):342-7. DOI: 10.1016/j.arth.2009.01.014. View