The Significance of Metal Staining on Alumina Femoral Heads in Total Hip Arthroplasty

Bal, B. Sonny; Rahaman, Mohamed N.; Aleto, Thomas; Miller, F. Scott; Traina, Francesco; Toni, Aldo

doi:10.1016/j.arth.2006.02.155

Cited by 33 publications

(22 citation statements)

References 23 publications

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“…In addition, the vast majority of patients (89%) had either a 32 or 36 millimeter diameter bearing surface. Either of these factors or a combination of the two may explain our low rate of [1,28]. Based upon this observation, we believe it is appropriate to consider revision for the unstable ceramic-on-ceramic total hip replacement.…”

Section: Discussionmentioning

confidence: 79%

“…Patients also experienced the squeak while sitting (N = 1, 14%), moving one's leg (N = 1, 14%), and going up and down stairs (N = 1, 14%). No patients reported the squeaking substantially affected their quality of life, which was defined as a score greater than or equal to 6 on a 10 point scale (mean = 2, range, [1][2][3][4][5]. No patient reported that the noise was associated with pain.…”

Section: Resultsmentioning

confidence: 99%

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Ceramic-on-Ceramic Total Hip Arthroplasty: Incidence of Instability and Noise

Schroder

Bornstein

Bostrom

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Alternative bearing materials in THA have been developed to reduce the incidence of osteolysis. Alumina-on-alumina bearings exhibit extremely low wear rates in vitro, but concerns exist regarding component impingement with the potential for dislocation and the occurrence of noise. Questions/purposes We determined generation of squeaking and the relationship between squeaking and component position. Methods We prospectively entered 436 alumina-on-alumina, cementless, primary THAs in 364 patients into our institutional database. All procedures were performed with the same surgical technique and the same implant. We obtained Harris Hip scores and a noise questionnaire and assessed radiographic component position and loosening. We determined the difference in abduction angle between squeakers and nonsqueakers. Minimum followup was 2 years (average, 3.5 years; range, 2.0-6.2 years).

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Section: Discussionmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 99%

Ceramic-on-Ceramic Total Hip Arthroplasty: Incidence of Instability and Noise

Schroder

Bornstein

Bostrom

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Risk factors for metal deposition are microseparation [15], dislocations [18], surgical errors [1], or contamination of the synovial fluid with metal particles as a consequence of abrasive neck-socket impingement [6]. Dislocations are unlikely causes, as these did not occur in our revised cases and occurred only once in all of our squeaking cases.…”

Section: Discussionmentioning

confidence: 82%

High Incidence of Squeaking in THAs with Alumina Ceramic-on-ceramic Bearings

Keurentjes

Kuipers

Wever

et al. 2008

Clinical Orthopaedics &Amp; Related Research

205

147

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Ceramic-on-ceramic bearings in THA are a popular alternative to overcome wear concerns in traditional metal-polyethylene bearings. However, squeaking is a potentially worrisome phenomenon in ceramic-onceramic THAs which we observed in some of our patients. We reviewed all 42 patients who underwent 43 ceramicon-ceramic noncemented THAs during the time of the study. Squeaking, defined as a reproducible sound of squeaking, clicking, or grating, occurred in nine of 43 implants (20.9%). Standard radiographs were normal. We used CT imaging to determine cup anteversion and inclination angles, comparing the squeaking hips with those of a randomly selected control group, but found no differences. We then hypothesized specific design features (stem size, cup size, head size, and neck length of the head) would be risk factors for squeaking. We found a difference in neck length between squeaking and nonsqueaking implants. A neck length of -4 mm or shorter resulted in a relative risk of 5.56 (95% confidence interval, 1.14-27.01) for squeaking. We found a high incidence of squeaking in our population, and we believe this phenomenon is an underreported side effect of these types of bearings. A short neck length of the femoral implant was a risk factor for squeaking in ceramic-on-ceramic THA. Level of Evidence: Level III, therapeutic study.

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“…The first generation is called inert ceramics, which aimed to substitute natural bone. For example, zirconia [49][50][51][52], titanium [53][54][55] and alumina [56][57][58] are primarily used in fabrication of femoral heads to substitute the damaged bones [59]. Although these ceramics are biocompatible, the living body usually reacts against the implants because they are foreign, and these implants themselves are likely to never transform into bone.…”

Section: Evolution Of Bioceramics In Hard Tissue Engineeringmentioning

confidence: 99%

A review of protein adsorption on bioceramics

et al. 2012

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Bioceramics, because of its excellent biocompatible and mechanical properties, has always been considered as the most promising materials for hard tissue repair. It is well know that an appropriate cellular response to bioceramics surfaces is essential for tissue regeneration and integration. As the in vivo implants, the implanted bioceramics are immediately coated with proteins from blood and body fluids, and it is through this coated layer that cells sense and respond to foreign implants. Hence, the adsorption of proteins is critical within the sequence of biological activities. However, the biological mechanisms of the interactions of bioceramics and proteins are still not well understood. In this review, we will recapitulate the recent studies on the bioceramic -protein interactions.

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The Significance of Metal Staining on Alumina Femoral Heads in Total Hip Arthroplasty

Cited by 33 publications

References 23 publications

Ceramic-on-Ceramic Total Hip Arthroplasty: Incidence of Instability and Noise

Ceramic-on-Ceramic Total Hip Arthroplasty: Incidence of Instability and Noise

High Incidence of Squeaking in THAs with Alumina Ceramic-on-ceramic Bearings

A review of protein adsorption on bioceramics

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