title: Alumina inlay failure in cemented polyethylene-backed total hip arthroplasty.
abstract: Alumina-on-alumina bearings for THA have markedly improved in mechanical properties through advances in technology; however, alumina fracture is still a concern. We retrospectively reviewed 77 patients (82 hips) with cemented alumina-on-alumina THAs to identify factors relating to alumina failure. The mean age of the patients at surgery was 63 years. The prostheses had a cemented polyethylene-backed acetabular component with an alumina inlay and a 28-mm alumina head. Revision surgery was performed because of alumina inlay failure in four hips (three fractures and one dissociation; 5.6%), deep infection in two, and recurrent dislocation in one. The 8-year survival rate was 90.7% with revision for any reason and 94.4% with revision for alumina failure as the end point. There were no differences in age, body mass index, gender, mobility, function, abduction angle, or size of component among the four hips with alumina failure and the remaining 68 hips without it; however, radiolucent lines in the sockets were more apparent in four cases with alumina inlay failure. This alumina-on-alumina THA thus yielded unsatisfactory medium-term results because we observed a high rate of catastrophic alumina inlay failure.
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. kentucky@msic.med.osaka-cu.ac.jp
authors.forename: Kentaro
authors.initials: K
authors.lastname: Iwakiri
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Iwaki
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Minoda
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ohashi
authors.forename: Kunio
authors.initials: K
authors.lastname: Takaoka
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000537:Aluminum Oxide; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001672:Biocompatible Materials; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D020959:Polyethylene; D000537:Aluminum Oxide