Ceramic-ceramic and metal-polyethylene total hip replacements: comparison of pseudomembranes after loosening.
We made a semiquantitative study of the comparative histology of pseudomembranes from 12 loose cemented ceramic-ceramic and 18 metal-polyethylene total hip replacements. We found no significant difference in cellular reaction between the two groups, but there was a major difference in the origin of the particulate debris. In the metal-polyethylene group, polyethylene of articular origin was predominant, while in the ceramic-ceramic group the cellular reaction appeared to be a response to zirconia ceramic particles used to opacify cement used for fixation. Isolation and characterisation of the debris showed that the zirconia particles formed the greatest proportion (76%) in ceramic-ceramic hips, while alumina debris of articular origin formed only 12%. Our study has indicated that aseptic loosening of ceramic cups is not due to a response to debris generated at the articular interface, but to mechanical factors which lead to fragmentation of the cement.
Lerouge
S
S
Institute of Biomedical Engineering, Ecole Polytechnique, Montreal, Canada.
Huk
O
O
Yahia
L
L
Witvoet
J
J
Sedel
L
L
D001843:Bone Cements / Q000009:adverse effects; D002516:Ceramics / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D006615:Hip / Q000473:pathology*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008566:Membranes / Q000473:pathology; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D011095:Polyethylenes / Q000009:adverse effects*; D011475:Prosthesis Failure; D015040:Zirconium / Q000009:adverse effects
D001843:Bone Cements; D003287:Contrast Media; D008670:Metals; D011095:Polyethylenes; D015040:Zirconium; C028541:zirconium oxide