Fracture of a Titanium Sleeve-encased Third-generation Ceramic Liner in a Modern THA.
Summary of "Fracture of a Titanium Sleeve-encased Third-generation Ceramic Liner in a Modern THA."
Due to their excellent tribology, ceramics are increasingly used for total hip arthroplasty (THA) in young patients. Fracture rates for contemporary ceramics range from 0% to 0.004%. Recently, ceramic liners are encased in a titanium sleeve to further decrease the chances of fracture. We encountered 1 case of a metal-encased acetabular liner fracture in a ceramic-on-ceramic articulation in a series of 764 hips. Our literature review revealed no reports of metal-encased ceramic liner fracture.A 60-year-old woman presented 27 months after a bilateral ceramic-on-ceramic THA. She reported mechanical grinding and clicking from the left hip on extension. There was no history of trauma or fall. Examination revealed a nonantalgic gait and audible-palpable crepitations on the left hip. Range of motion of the left hip was intact with no subluxation. Radiographs revealed fractured ceramic insert and an excessively anteverted socket on the left side. Intraoperative findings revealed gross impingement in the form of indentation of the metal femoral neck against the elevated metal rim encasing the liner. Revision THA was performed using an uncemented polyethylene liner while retaining the well-fixed cup and stem. The Harris Hip Score at 4.5-year follow-up was 100, with no evidence of osteolysis or polyethylene wear.
Affiliation
Journal Details
This article was published in the following journal.
Name: Orthopedics
ISSN: 1938-2367
Pages: e682-4
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21956067
- DOI: http://dx.doi.org/10.3928/01477447-20110826-30
Medical and Biotech [MESH] Definitions
Bone Plates
Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999)
Monteggia's Fracture
Fracture in the proximal half of the shaft of the ulna, with dislocation of the head of the radius.
Fracture Fixation
The use of metallic devices inserted into or through bone to hold a fracture in a set position and alignment while it heals.
Colles' Fracture
Fracture of the lower end of the radius in which the lower fragment is displaced posteriorly.
Fracture Fixation, Internal
The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment.
PubMed Articles
Fracture of the Alumina-bearing Couple Delta Ceramic Liner.
The fracture rate of third-generation ceramic liners is greatly reduced compared with first- and second-generation liners because of improvements in the design and manufacturing process. Fractures of...
BACKGROUND: The ceramic-on-ceramic (CoC)-bearing couple in total hip arthroplasty (THA) was developed to reduce the wear debris and osteolysis. Although the mechanical strength of third-generation cer...
Metal neck and liner impingement in ceramic bearing total hip arthroplasty.
Although impingement between the neck of the metallic stem and the ceramic liner has been suspected to be the cause of ceramic liner failure in ceramic-on-ceramic total hip arthroplasty (THA), no repo...
Do Obesity and/or Stripe Wear Increase Ceramic Liner Fracture Risk? An XFEM Analysis.
BACKGROUND: Hypothesized risk factors for fracture of ceramic liners include impingement, edge-loading, and cup malpositioning. These risk factors are similar to those for generation of stripe wear. H...
Factors Affecting Modular Acetabular Ceramic Liner Insertion: A Biomechanical Analysis.
BACKGROUND: Ceramic liner fracture is a concern in THA. However, it is unclear what factors influence the risk of facture. To study these factors under controlled conditions, we...
Clinical Trials
Ceramic-on-Ceramic Total Hip Arthroplasty and Squeaking: Influence of Component Design
The investigators want to examine if specific acetabular liner designs can be a contributing factor to audible squeaking associated with CoC bearings. The aim of the present study is to co...
Cementless New Alumina-zirconia Ceramic Bearing Total Hip Arthroplasty (THA) in Asian Patients
This study will evaluate a midterm clinical and radiologic outcome patients who undergo new alumina-zirconia composite ceramic bearing THA.
The Comparison of 32mm and 28mm Head Components in Alumina-alumina Total Hip Arthroplasty
It has been postulated that use of a larger femoral head could reduce the risk of dislocation after total hip arthroplasty, but only limited clinical data have been presented in third gene...
In Vivo Wear of All-ceramic and Metal-ceramic Crowns and Their Enamel Antagonists After Three Years
This study aims determine the wear rates of enamel versus enamel and enamel versus ceramic in human beings in relation to the microstructure of the ceramic material. Specific aims of the...
Titanium Elastic Nails in the Treatment of Pediatric Femur Fractures
Titanium elastic nails in the pediatric femoral fractures: A prospective randomized clinical trial of eliminating nail protrusion to decrease soft tissue complications
