Fracture of ceramic heads in total hip replacement

Abstract

After introduction of ceramics in total hip replacement, there have been several studies on wear and fracture of the femoral head component. Though reports on fractures are few, we saw four fractures within 2 months. In all patients, a cementless hip prosthesis by four different surgeons was implanted between 3/2001 and 2/2004. In three patients, a ceramic-on-polyethylene pair and in one, a ceramic-on-ceramic pair was used. Only one patient suffered an adequate trauma. The mean survival of the ceramic head was 27 months (11-42). In two patients with polyethylene inlays, the inlay showed signs of wear out due to the fractured head. All four revision surgeries had a good outcome with satisfying results and no complications. Though we observe the postoperative development after implantation of ceramic components closely, we still believe that ceramics in total hip replacement in young and active patients are indicated with good long term results.

The influence of stem taper re-use upon the failure load of ceramic heads

“…Contrary to previous studies [12,23,24], in the present study all damage was caused by actual (in-vitro) head failure and not artificial manipulation of the taper surface (except for cleaning after each fracture test). The shape and number of the ceramic fragments from the low fracture loads matches well with reported in-vivo fractures [10,11,[28][29][30] indicating that the test design reproduced clinical damage of male tapers. Even though the used offset length does not represent the worst case situation in terms of ceramic head wall thickness, no qualitative changes are to be expected for short heads except a probably slightly reduced overall load-level.…”

Fracture of Ceramic Bearing Surfaces following Total Hip Replacement: A Systematic Review

“…The majority of these manuscripts are case reports and retrieved analysis of fractured heads [28, 29, 35–41, 43–45, 48–51]. The remaining studies reported on the incidence of fractured ceramic heads in retrospective case-series on the mid to long term outcomes of COC hip prostheses [20–22, 24–28, 30, 42, 46]. A trauma was involved in the generation of fractures in 7 reports [24, 26, 27, 35, 42, 46, 48].…”

“…The remaining studies reported on the incidence of fractured ceramic heads in retrospective case-series on the mid to long term outcomes of COC hip prostheses [20–22, 24–28, 30, 42, 46]. A trauma was involved in the generation of fractures in 7 reports [24, 26, 27, 35, 42, 46, 48]. Only two papers specifically focused on risk factors for ceramic head fractures.…”

Ceramic Head Fracture in Ceramic-on-Polyethylene Total Hip Arthroplasty

“…Thus, ceramic-on-polyethylene articulation is gradually spotlighted to reduce impact force between hard ceramic materials, as well as lower wear rates of polyethylene liner than metal-on-polyethylene articulation 1,6. Recently, there are a few reports of ceramic head fracture with polyethylene liner 7,8. Herein, we report a case of ceramic head fracture 12 years after THA with polyethylene liner.…”