Metal neck and liner impingement in ceramic bearing total hip arthroplasty.
Summary of "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 report has directly demonstrated microscopic damage on ceramic liner. We performed 18 reoperations on 18 patients who had undergone third generation ceramic-on-ceramic THA. Considering impingement, 16 patients, who were reoperated more than 1 year after previous ceramic bearing THA, were evaluated. Retrieved alumina liners, showing evidence of impingement, were examined by means of visual inspection and scanning electron microscopy (SEM). Four of the 16 hips showed neck notching and black stained liners, evidence of metallic neck to ceramic impingement. Impinged alumina bearings had been implanted for an average of 62.5 months (range: 35-99 months) before reoperation. SEM of the black stained area demonstrated disruptive wear and loss of surface integrity. Furthermore, one liner had multiple microcracks, and its cross-sectional SEM analysis revealed one microcrack propagating into the deep portion of the ceramic liner. Our observations suggest that metal neck-to-ceramic impingement in ceramic-on-ceramic THA can cause microcrack formation in ceramic liner. J. Orthop. Res. © 2010 Orthopaedic Research Society.
Affiliation
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Journal Details
This article was published in the following journal.
Name: Journal of orthopaedic research : official publication of the Orthopaedic Research Society
ISSN: 1554-527X
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20865775
- DOI: http://dx.doi.org/10.1002/jor.21246
Medical and Biotech [MESH] Definitions
Metal Ceramic Alloys
The fusion of ceramics (porcelain) to an alloy of two or more metals for use in restorative and prosthodontic dentistry. Examples of metal alloys employed include cobalt-chromium, gold-palladium, gold-platinum-palladium, and nickel-based alloys.
Dental Porcelain
A type of porcelain used in dental restorations, either jacket crowns or inlays, artificial teeth, or metal-ceramic crowns. It is essentially a mixture of particles of feldspar and quartz, the feldspar melting first and providing a glass matrix for the quartz. Dental porcelain is produced by mixing ceramic powder (a mixture of quartz, kaolin, pigments, opacifiers, a suitable flux, and other substances) with distilled water. (From Jablonski's Dictionary of Dentistry, 1992)
Arthroplasty, Replacement
Partial or total replacement of a joint.
Arthroplasty, Replacement, Finger
Partial or total replacement of one or more FINGERS, or a FINGER JOINT.
Neck Dissection
Dissection in the neck to remove all disease tissues including cervical LYMPH NODES and to leave an adequate margin of normal tissue. This type of surgery is usually used in tumors or cervical metastases in the head and neck. The prototype of neck dissection is the radical neck dissection described by Crile in 1906.
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