Ceramic Liner Fracture and Impingement in Total Hip Arthroplasty

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• 作者：Amy Steinhoff MD (1)
  Victor Hakim MD (2)
  Richard H. Walker MD (3)
  Clifford W. Colwell Jr. MD (3) (4)
  Steven N. Copp MD (3)
  
  1. Department of Orthopedics ; Kaiser Permanente ; San Diego ; CA ; USA
  2. Hakim Joint Replacement ; Plano ; TX ; USA
  3. Division of Orthopaedic Surgery ; Scripps Clinic ; 10666 North Torrey Pines Road ; MS116 ; La Jolla ; CA ; 92037 ; USA
  4. Shiley Center for Orthopaedic Research & Education at Scripps Clinic ; La Jolla ; CA ; USA
  
• 关键词：total hip arthroplasty ; ceramic fracture ; metallosis ; ceramic bearing ; acoustic phenomenon
• 刊名：HSS Journal?
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：11
• 期：1
• 页码：50-55
• 全文大小：3,900 KB
• 参考文献：1. Allain, J, Goutallier, D, Voisin, MC, Lemouel, S (1998) Failure of a stainless-steel femoral head of a revision total hip arthroplasty performed after a fracture of a ceramic femoral head. A case report. J Bone Joint Surg Am 80: pp. 1355-1360
  2. Allain, J, Roudot-Thoraval, F, Delecrin, J, Anract, P, Migaud, H, Goutallier, D (2003) Revision total hip arthroplasty performed after fracture of a ceramic femoral head. A multicenter survivorship study. J Bone Joint Surg 85-A: pp. 825-830
  3. Amanatullah, DF, Landa, J, Strauss, EJ, Garino, JP, Kim, SH, Cesare, PE (2011) Comparison of surgical outcomes and implant wear between ceramic-ceramic and ceramic-polyethylene articulations in total hip arthroplasty. J Arthroplasty 26: pp. 72-77 CrossRef
  4. Boutin, P, Christel, P, Dorlot, JM (1988) The use of dense alumina-alumina ceramic combination in total hip replacement. J Biomed Mater Res 22: pp. 1203-1232 CrossRef
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  6. D'Antonio, J, Capello, W, Manley, M, Bierbaum, B (2002) New experience with alumina-on-alumina ceramic bearings for total hip arthroplasty. J Arthroplasty 17: pp. 390-397 CrossRef
  7. D'Antonio, JA, Capello, WN, Manley, MT, Naughton, M, Sutton, K (2005) A titanium-encased alumina ceramic bearing for total hip arthroplasty: 3- to 5-year results. Clin Orthop Relat Res 441: pp. 151-158 CrossRef
  8. Fritsch, EW, Gleitz, M (1996) Ceramic femoral head fractures in total hip arthroplasty. Clin Orthop Relat Res 328: pp. 129-136 CrossRef
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  12. Mai, K, Verioti, C, Ezzet, KA, Copp, SN, Walker, RH, Colwell, CW (2010) Incidence of 'squeaking' after ceramic-on-ceramic total hip arthroplasty. Clin Orthop Relat Res 468: pp. 413-417 CrossRef
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  15. Murali R, Bonar SF, Kirsh G, Walter WK, Walter WL. Osteolysis in third-generation alumina ceramic-on-ceramic hip bearings with severe impingement and titanium metallosis. / J Arthroplasty. 2008; 23(8): 1240.e13-e19.
  16. Nevelos, J, Ingham, E, Doyle, C (2000) Microseparation of the centers of alumina-alumina artificial hip joints during simulator testing produces clinically relevant wear rates and patterns. J Arthroplasty 15: pp. 793-795 CrossRef
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• 刊物主题：Surgical Orthopedics; Orthopedics; Rheumatology; Sports Medicine; Imaging / Radiology; Anesthesiology;
• 出版者：Springer US
• ISSN：1556-3324

文摘

Background Ceramic-on-ceramic bearing surfaces were developed to provide an alternate to metal-on-polyethylene to decrease wear-induced osteolysis in total hip arthroplasty patients. In an effort to decrease the risk of ceramic acetabular component fracture or damage during implantation, a raised metal rim was added. Questions/Purposes How many fractures or impingements have occurred in our population of patients with ceramic liners with raised rims? Methods With IRB-approved consent, a case series was reviewed from a single center registry and 4 of 169 patients were identified who had revision hip surgery with the ceramic liner with a raised metal rim: one for ceramic liner fracture and three for metallosis, pain, and squeaking. Implant alignment and operative findings were reviewed. Results One ceramic liner fracture and three cases of metallosis from impingement of the femoral neck on the posterior elevated metal rim of the acetabular liner were observed at revision. The femoral neck in each patient had a divot that corresponded to a divot in the posterosuperior liner rim. Three of the four patients had audible squeaking or clicking prior to revision. A total of 3% of patients in this series had clinically significant impingement with this implant type. Conclusion Acoustic phenomenon in a ceramic on ceramic bearing surface should be investigated with a cross-table lateral radiograph to evaluate component position. If symptomatic impingement is demonstrated, revision should be considered to avoid failure from metallosis or fracture.