[Titanium deposits on the ceramic heads of dislocated total hip replacements].
BACKGROUND
In cases of revision total hip replacement (THR) having acetabular titanium components with dislocations in the past, metallic deposits are frequently found on the ceramic heads. The aim of this study was to determine whether the metallic deposits increase surface roughness in definite areas.


METHODS
Ten ceramic heads of revised THR which showed metallic deposits were investigated. The patients suffered from one to six dislocations. The prosthesis lifetime ranged from 2 weeks to 12 years. Surface structure was investigated in a scanning electron microscope (LEO 1525), and the metallic deposits characterised by means of energy dispersive x-ray analysis (EDX).


RESULTS
In the area of the metallic deposits, titanium was detected by EDX. Edges with a significant increase in surface roughness were observed, partially accompanied by damage to the surface structure and loosening of Al(2)O(3) particles.


CONCLUSIONS
Titanium deposits increase surface roughness in definite areas, which probably causes wear to the ceramic-ceramic or ceramic-polyethylene articulations due to different roughness values and surface properties. Further investigations are necessary in order to determine the importance of these findings with respect to wear and loosening of total hip arthroplasty.
Orthopädische Klinik Wichernhaus im Krankenhaus Rummelsberg, Abteilung für infantile Zerebralparese, Rummelsberg 71, 90592 Schwarzenbruck, Germany. Manolikakis.Georg@Rummelsberger.net schuh-alexander@t-online.de
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A
Schuh
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Holzwarth
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Kachler
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Göske
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Zeiler
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D002516:Ceramics; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D013499:Surface Properties; D013997:Time Factors; D014025:Titanium
D014025:Titanium