Abstract
Results obtained with ceramic bearings in total hip arthroplasty have been disappointing because of increased component loosening rates primarily caused by design issues and use of low-quality ceramic, resulting in fracture and debris generation. Although new-generation ceramics have produced a reduced incidence of fracture, concerns still persist about the fracture of ceramic liners. After investigating the underlying cause of fracture in contemporary ceramic-on-ceramic bearings, we sought to determine the incidence of ceramic liner fracture and to formulate technical guidelines for avoiding catastrophic failure. Between January 2000 and January 2005, we prospectively studied a consecutive series of 147 patients (179 hips) who had undergone primary cementless total hip arthroplasty with modern ceramic-on-ceramic articulation so that we could detect ceramic liner fracture. The mean length of the follow-up period was 3.1 years (range, 2–6.5 years). By the latest follow-up examination, delayed ceramic liner fracture had occurred in 3 hips (1.7%). One liner was chipped during insertion because of eccentric seating of the liner. Head fracture occurred in 2 hips (1.1%). Despite the improved wear characteristics of modern ceramic-on-ceramic articulations, a catastrophic failure with ceramic liner failure was still observed during short-term follow-up monitoring. This finding prompted us to define important technical aspects to be considered to minimize ceramic liner fractures.
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© 2007 Steinkopff Verlag
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Min, BW. et al. (2007). Tips and Tricks: Fracture of a Ceramic Insert with modern Ceramic Total Hip Replacement. In: Chang, JD., Billau, K. (eds) Bioceramics and Alternative Bearings in Joint Arthroplasty. Ceramics in Orthopaedics. Steinkopff. https://doi.org/10.1007/978-3-7985-1783-7_44
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DOI: https://doi.org/10.1007/978-3-7985-1783-7_44
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