Midterm Results of Delta Ceramic-on-Ceramic Total Hip Arthroplasty

Hamilton, William G.; McAuley, James P.; Blumenfeld, Thomas J.; Lesko, J; Himden, Sam; Dennis, Douglas A.

doi:10.1016/j.arth.2015.02.047

Cited by 63 publications

(51 citation statements)

References 60 publications

(69 reference statements)

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“…Our findings suggest that acetabular fixation is a main issue whether or not the bearing includes ceramic components, despite improvement in cementless fixation [12,15,29,30]. The fixation of CoC cementless cups has been improved using modern porous coatings [4,13,14,30] but remains a weak point of this bearing, particularly when considering the low rate of osteolysis that, contrary to MoP, did not contribute to cup loosening. Our results differ from the study by Porat et al [27] that identified femoral loosening as the main reason for revision of CoC THA (13 of 38 [34%]).…”

Section: Discussionmentioning

confidence: 99%

“…This study was not designed to provide data regarding cup orientation, which may explain why none of the factors investigated were associated with bulk ceramic rupture considering component orientation as a cofounding factor. The introduction of Delta ceramic was supposed to reduce the risk of ceramic fracture to near zero [13,25], but four of the 12 instances of bulk ceramic components breakage involved Delta components (two heads, two inserts), making this argument questionable. Likewise, revisions because of impingement were done independent of the bearing diameter, suggesting that use of 36-mm CoC bearings does not prevent impingement.…”

Section: Discussionmentioning

confidence: 99%

“…However, with more frequent use of ceramics, other concerns such as squeaking have emerged with a frequency of 0.5% to 20% [2,5,6,18,27]. All these limitations expose CoC THAs to reoperation with the 10-year survival rate ranging from 62% to 97% [12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Do the Reasons for Ceramic-on-ceramic Revisions Differ From Other Bearings in Total Hip Arthroplasty?

Migaud

Putman

Kern

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Do the Reasons for Ceramic-on-ceramic Revisions Differ From Other Bearings in Total Hip Arthroplasty?

Migaud

Putman

Kern

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…At the time THAs were performed during this investigation, MoM and CoC bearings were thought to have numerous potential advantages versus a traditional, MoP bearing [11,13,27,33]. However, published investigations began to report the phenomenon of noise associated with hard-on-hard bearings [1,2,8,14,24]. The cause of noise generation in hardon-hard bearings is an area of much debate, because some studies have pointed toward component design [30,31], others have reported decreased acetabular inclination and anteversion to be risk factors in CoC implants [24], whereas increased acetabular inclination has been noted as a risk factor in MoM implants [4].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, published reports began to note the phenomenon of noise associated with hard-on-hard bearings [1,2,8,14,24]. However, prior reports have been limited by the potential for observer bias, the variability in which noise generation was assessed, and a lack of correlation with patient-reported outcomes.…”

Section: Introductionmentioning

confidence: 99%

Hard-on-Hard Bearings Are Associated With Increased Noise Generation in Young Patients Undergoing Hip Arthroplasty

Nam

Barrack

Johnson

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Patient-perceived noise from prostheses after total hip arthroplasty (THA) does occur, yet questions remain including the overall frequency of this finding, demographic and prosthesis-related factors, and the association of noise generation with patient-reported outcomes. Questions/purposes The purposes of this study were (1) to determine the frequency with which patients report noise coming from the hip after THA; (2) to identify patient and prosthesis-related factors associated with noise generation; and (3) to ascertain if noise generation is associated with pain or functional impairment after THA. Methods A five-center study was designed to quantify the degree of residual symptoms and functional deficits in patients undergoing THA. Three centers were academic practices, whereas two centers were private practices that provided training programs for orthopaedic residents and fellows. Each contributing surgeon was fellowship-trained and specialized in joint replacement. Inclusion criteria for this study were (1) men between 18 and 60 years old and women between 18 and 55 years old; (2) patients requiring primary hip surgery as a result of noninflammatory arthritis such as osteoarthritis, traumatic arthritis, or avascular necrosis; (3) a UCLA activity score of 6 or more before they were limited by pain; and (4) patients who had undergone a primary THA within 1 to 4 years before the start of the study and had a minimum of 1 year of clinical followup. Attempts were made to contact all identified patients meeting these inclusion criteria. Data were collected by an independent, third-party survey center blinded to the implant design and bearing surface used who administered questionnaires about residual symptoms, function, and pre-and postoperative activity levels using previously published survey instruments. Patients were specifically queried regarding perceived noise from their THA. We retrospectively identified 1242 eligible patients. Of the 1242 patients, 105 were found to have exclusions during the screening section of the questionnaire: postoperative infection (six THAs), fracture (two), dislocation (seven), or revision (17); limited activity level because of an operation on the opposite hip (34); and premorbid UCLA score of less than 6 (39). In addition, 128 individuals refused to participate, 156 were never available, 108 were not found as a result of a bad address/phone number, 48 were contacted but did not complete the interview, nine Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. had died, and six had a language barrier. This left 682 of the 1137 eligible patients with completed surveys (60% response rate). The mean age was 50 ± 8 years at the time of surgery with 63% being men, and they were contacted at a mean of 3 ± 1 years postoperatively. Bearing surfaces (femoral head...

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Zirconia phase transformation in retrieved, wear simulated, and artificially aged ceramic femoral heads

Parkes

Sayer

Goldhofer

et al. 2017

Journal Orthopaedic Research

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Zirconia in Zirconia toughened alumina ceramic hip replacements exists in an unstable state and can transform in response to stress giving the material improved fracture toughness. Phase transformation also occurs under hydrothermal conditions such as exist in vivo. To predict the hydrothermal aging that will occur in vivo accelerated aging procedures have been used, but validation of these models requires the study of retrieved hip joints. Here 26 retrievals are analysed to determine the degree of phase transformation in vivo. These were compared with virgin heads, heads that had undergone the accelerated aging process and heads wear tested to 5 million cycles in a hip simulator. Monoclinic content and surface roughness were measured using Raman spectroscopy and white light interferometry respectively. The monoclinic content for retrieved heads was 28.5% ± 7.8, greater than twice that in virgin, aged, or wear tested heads and did not have a significant correlation with time, contrary to the predictions of the hydrothermal aging model. The surface roughness for retrieved heads in the unworn area was not significantly different to that in virgin, aged, or unworn areas of wear tested heads. However in worn areas of the retrieved heads, the surface roughness was higher than observed in wear simulator testing. These results indicate that current testing methodologies do not fully capture the operational conditions of the material and the real performance of future new materials may not be adequately predicted by current pre‐clinical testing methods. © 2017 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society 35:2781–2789, 2017.

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Midterm Results of Delta Ceramic-on-Ceramic Total Hip Arthroplasty

Cited by 63 publications

References 60 publications

Do the Reasons for Ceramic-on-ceramic Revisions Differ From Other Bearings in Total Hip Arthroplasty?

Do the Reasons for Ceramic-on-ceramic Revisions Differ From Other Bearings in Total Hip Arthroplasty?

Hard-on-Hard Bearings Are Associated With Increased Noise Generation in Young Patients Undergoing Hip Arthroplasty

Zirconia phase transformation in retrieved, wear simulated, and artificially aged ceramic femoral heads

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