Revision Total Hip Arthroplasty with Sandwich-type Ceramic on Ceramic Liner

Abstract

In the past, surgical techniques, implant designs, and research on bone growth factors have focused on the arthroplasty field. However, as wear and loosening became the most common causes of arthroplasty failure, many investigators have attempted to identify a new articular surface. One is the improvement of the conventional polyethylene liner, and the other is developing a new articular surface material. Among these, ceramic is the most recently developed articular material. Ceramic-on-ceramic articulation was invented by Pierre Boutin (France) in 1970. Mittlemeier-type ceramic articulation was introduced by Miller to the US and received FDA approval in 1982. Recent articles have shown the successful results of ceramic articulation during more than 10 years follow-up. Regarding the aspect of wear rate, ceramic is the most satisfactory material. Unfortunately, the hardness of alumina ceramic causes a high risk of loosening of acetabular cup [9] and consequent fracture of the femoral head and liner [3]. As this complication is related to inadequate resorption of the dynamic load on the articular surface, the new, low-stiff sandwich liner was introduced. We analyzed the short-term results of the sandwich liner in total hip arthroplasty in revisional cases.