Ten- To 14-Year Results of a Ceramic Hip Prosthesis

Winter, Michael; Griss, P.; Scheller, G.; Moser, Thomas

doi:10.1097/00003086-199209000-00009

Cited by 62 publications

(34 citation statements)

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“…Alumina ceramic-on-ceramic THR has been in clinical use for more than 25 years. Initial design-related complications such as fractures of the ball head and breakage of ceramic sockets [45][46][47][48][49] were reduced to a minimum by applying changes at the ball-cone junction and by improving the quality of the ceramic product. polyethylene revision cases, 22 a lower rate of degeneration of macrophages detected when alumina particles were phagocytosed instead of Co-based alloy particles, 11,35 and better chemotaxis and less necrosis of alumina-laden macrophages.…”

Section: Discussionmentioning

confidence: 99%

Wear debris from two different alumina-on-alumina total hip arthroplasties

Böhler

Mochida

Bauer

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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W e compared wear particles from two different designs of total hip arthroplasty with polycrystalline alumina-ceramic bearings of different production periods (group 1, before ISO 6474: group 2, according to ISO 6474). The neocapsules and interfacial connective tissue membranes were retrieved after mean implantation times of 131 months and 38 months, respectively. Specimen blocks were freed from embedding media, either methylmethacrylate or paraffin and digested in concentrated nitric acid. Particles were then counted and their sizes and composition determined by SEM and energy-dispersive x-ray analysis (EDXA).The mean numbers and sizes of most alumina wear particles did not differ for both production periods, but the larger sizes of particle in group 1 point to more severe surface destruction. The increased metal wear in group 2 was apparently due to alumina-induced abrasion of the stems. In this study the concentrations of particles in the periprosthetic tissues were 2 to 22 times lower than those observed previously with polyethylene and alumina/polyethylene wear couples. [Br] 2000;82-B:901-9. J Bone Joint Surg Received 11 December 1998; Accepted after revision 20 September 1999The size, shape and composition of wear particles play a central role in the development of aseptic loosening and osteolysis in total hip replacement (THR). [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Various studies have shown the good performance of the alumina ceramic-on-ceramic articular surfaces in terms of frictional behaviour, low annual rates of wear and relatively low reactivity of debris in the periprosthetic tissues, compared with polyethylene wear from metal-polyethylene couples. [15][16][17][18][19][20][21][22][23] Light-microscope studies of membranes around revised ceramic THRs reported sizes of alumina particle of between 1 and 3 m which is similar to the grain size of alumina used for production. 15,24,25 Since a size of 1 m is at the lower limit for light microscopy, more sensitive methods have been developed to evaluate submicron debris in tissue membranes. 26-28The purpose of the present study was to describe the histology of periarticular tissues around failed alumina ceramic-on-ceramic total hip prostheses and to compare the tissue concentration and physical characteristics of isolated wear particles originating from two types of Al 2 O 3 ceramic used for these THRs: 1) a series of cementless, monolithic ceramic cups with ceramic heads, produced after 1975 but before the ISO 6474; and 2) more recently manufactured ceramic inserts for a commercially pure (cp) Ti-backed acetabular cup and ceramic ball head (BIOLOX, according to ISO 6474; Ceramtec, Plochingen, Germany) with a Tialloy stem. We have compared our findings with the results from previously published studies which used identical techniques of isolation and characterisation of wear particles to analyse tissues adjacent to failed cemented and uncemented metal-polyethylene total hip prostheses. [26][27][28] Materials and Methods (Table I) Group 1. Betwee...

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Section: Discussionmentioning

confidence: 99%

Wear debris from two different alumina-on-alumina total hip arthroplasties

Böhler

Mochida

Bauer

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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“…Difficulty in controlling the tolerances of early metal-on-metal hips has been hypothesized to result in seizure of some metal bearings culminating in early loosening [72], whereas first-generation alumina components were prone to unacceptably high fracture rates [141]. Orthopaedic manufacturers clinically introduced carbon-fiber-reinforced UHMWPE (Poly II TM ; Zimmer, Inc, Warsaw, IN) [1,33,143] and high-pressure crystallized UHMWPE (Hylamer 1 ; DePuy Orthopaedics, Inc, Warsaw, IN) [23,86] in the 1970s and 1980s, respectively.…”

Section: History and Development Of Hxlpementioning

confidence: 99%

History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene

Kurtz

Gawel

Patel

2011

Clinical Orthopaedics &Amp; Related Research

411

282

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Background Highly crosslinked polyethylene (HXLPE) was introduced to reduce wear and osteolysis in total joint arthroplasty. While many studies report wear and osteolysis associated with HXLPE, analytical techniques, clinical study design and followup, HXLPE formulation and implant design characteristics, and patient populations differ substantially among investigations, complicating a unified perspective. Questions/purposes Literature on first-generation HXLPE was summarized. We systematically reviewed the radiographic wear data and incidence of osteolysis for HXLPE in hip and knee arthroplasty. Methods PubMed identified 391 studies; 28 met inclusion criteria for a weighted-averages analysis of two-dimensional femoral head penetration rates. To determine the incidence of osteolysis, we estimated a pooled odds ratio using a random-effects model.Results Weighted-averages analyses of femoral head penetration rates in HXLPE liners and conventional UHMWPE liners resulted, respectively, in a mean twodimensional linear penetration rate of 0.042 mm/year based on 28 studies (n = 1503 hips) and 0.137 mm/year based on 18 studies (n = 695 hips). The pooled odds ratio for the risk of osteolysis in HXLPE versus conventional liners was 0.13 (95% confidence interval, 0.06-0.27) among studies with minimum 5-year followup. We identified two clinical studies of HXLPE in TKA, preventing systematic analysis of outcomes. Conclusions HXLPE liner studies consistently report lower femoral head penetration and an 87% lower risk of osteolysis. Reduction in femoral head penetration or osteolysis risk is not established for large-diameter ([ 32 mm) metallic femoral heads or ceramic femoral heads of any size. Few studies document the clinical performance of HXLPE in knees.

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“…Application of alumina ceramics to total hip prosthesis has been investigated for the past two decades [4,7,9,15]. On the other hand, fewer efforts have been made to apply these materials to total knee prosthesis compare to hip prosthesis [1,10].…”

Section: Introductionmentioning

confidence: 99%

Clinical results of posterior cruciate ligament retaining TKA with alumina ceramic condylar prosthesis: comparison to Co–Cr alloy prosthesis

Majima

Yasuda

Tago

et al. 2007

Knee Surg Sports Traumatol Arthr

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In a prospective study, 194 knees undergoing total knee arthroplasty (110 knees with alumina ceramic prostheses; 84 knees with Co-Cr alloy prostheses) were clinically and radiologically evaluated. Average follow-up period was 66 months (36 to 124 months). Average age at the time of surgery was 66 years. In the ceramic prostheses, two revision surgeries were performed because of breakage of the tibial tray and late infection, whereas two revisions of the Co-Cr alloy prostheses were carried out due to loosening and late infection. In the other patients, there were no significant differences in clinical parameters (HSS knee score and range of motion) between the two prostheses. In radiological evaluation, we could not find any radiolucent lines around the femoral ceramic component, while radiolucency was present in 3 knees (3.6%) around the Co-Cr femoral component. Beneath the tibial tray, 3 knees (2.7%) showed a radiolucent line around the former prosthesis, while 8 knees (9.5%) demonstrated a radiolucent line around the latter prosthesis. Chi-square tests showed a significant difference in the occurrence of radiolucent line around both of the femoral and This study demonstrated that clinical results of the alumina ceramic PCL retaining total knee prosthesis are comparable to the standard Co-Cr alloy PCL retaining total knee prosthesis.Although we could not draw any conclusions regarding the superiority of the ceramic prosthesis with respect to UHMWPE wear and long-term survivorship, this report encouraged a long-term follow-up study on ceramic prostheses.

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Ten- To 14-Year Results of a Ceramic Hip Prosthesis

Cited by 62 publications

References 0 publications

Wear debris from two different alumina-on-alumina total hip arthroplasties

Wear debris from two different alumina-on-alumina total hip arthroplasties

History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene

Clinical results of posterior cruciate ligament retaining TKA with alumina ceramic condylar prosthesis: comparison to Co–Cr alloy prosthesis

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