[Fracture analysis of a ceramic liner. Is in hip endoprosthesis replacement of ceramic on ceramic components with only one of the corresponding partners justified?].
The good biomechanical and tribological properties, together with the excellent biocompatibility, of ceramic-on-ceramic components, make them a preferential choice for total hip replacement surgery, at least in Europe. We report on a man admitted as an outpatient with painless grating in the hip one year after replacement of a ceramic femoral head, but not of the ceramic inlay. Clinical and radiological findings were indicative of a broken liner. This was confirmed during revision surgery, during which it was replaced by a polyethylene inlay; although the ceramic head appeared intact, it was replaced by a metal head. Inspection of the surface of the broken liner in the scanning electron microscope (SEM) revealed signs of material failure. We recommend careful inspection of ceramic-on-ceramic articulating components during total hip revision surgery and if there is any uncertainty, replacement of both so as to avoid premature failure.
Jäger
M
M
Orthopädische Universitätsklinik Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf. Jaeger@med.uni-duesseldorf.de
Wild
A
A
Werner
A
A
Munz
D
D
Krauspe
R
R
D000368:Aged; D000537:Aluminum Oxide; D019544:Equipment Failure Analysis; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D013499:Surface Properties
D000537:Aluminum Oxide