Advanced wear of an Oxinium™ femoral head implant following polyethylene liner dislocation

Abstract

Oxinium™ (Smith & Nephew, Memphis, TN, US) has been used in hip arthroplasty since 2003. The surface coating is hard and provides low wear rates but if this surface coating is damaged, the soft metal core is at risk of accelerated wear. Previous reports have described accelerated wear following intra and postoperative hip dislocation. We report a case of advanced wear of an in situ Oxinium™ femoral head implant following a cracked acetabular liner. The liner had disengaged from the titanium shell, allowing the Oxinium™ head to articulate directly with the shell. The disengaged liner led to dislocation of the Oxinium™ head, with associated pronounced wear of the head and the acetabular cup. The patient had a successful revision procedure. We advise close follow-up of patients with Oxinium™ implants, especially if associated with dislocation and closed reduction.A low wear rate is a key element of long-term total hip arthroplasty survival. Ceramic femoral heads have lower wear rates than traditional cobalt-chrome when articulated with a polyethelene acetabular liner but ceramic material is brittle and fracture is a reported failure mechanism.

Oxidized Zirconium Total Knee Arthroplasty Implant Failure in a Patient With Knee Instability

“…Although oxidized zirconium could lengthen implant life and possibly decrease the need for revision on the basis of these studies, there is increasing evidence of accelerated wear and metallosis with oxidized zirconium THA implants after dislocation or reduction, leading to catastrophic failure [5,7,[12][13][14]21]. In addition, there have been at least 2 reports of catastrophic failure in patients with UKA secondary to dislocation of fixed polyethylene bearings [15,16].…”

Severe metallosis following oxidised zirconium wear in total hip arthroplasty

“…The findings are usually subtle and the debris is well tolerated by the patients. A few cases with characteristic radiographic findings are reported in the literature, but to the best of our knowledge, the present case is the most impressive due to the extent of the metallosis 2 3. Oxidised zirconium is a metallic alloy with a ceramic surface that combines the best of metal and ceramics.…”

Liner dissociation leading to catastrophic failure of an Oxinium femoral head

“…Tribe et al. [39] described a case of a cracked PE liner, allowing direct articulation of an Oxinium head with the acetabular cup, leading to accelerated femoral head wear.…”