Osteolysis in third-generation alumina ceramic-on-ceramic hip bearings with severe impingement and titanium metallosis.
The most common cause of long-term failure of total hip arthroplasty is osteolysis and aseptic loosening secondary to wear debris. Combinations of hard materials such as ceramic-on-ceramic generate smaller volumes of particulate wear debris than traditional combinations such as metal-on-polyethylene. We describe 2 cases where osteolysis arose in hips with third-generation alumina ceramic-on-ceramic couplings. Periarticular tissue in both cases contained titanium wear debris due to impingement of the neck of the titanium femoral component against the rim of the titanium shell and ceramic debris from edge loading wear (stripe wear) of the ceramic. It is not clear whether the titanium debris, the ceramic debris, or both caused the osteolysis. These cases illustrate that the risk of osteolysis persists, even with third-generation alumina ceramics.
Murali
Rajmohan
R
Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park NSW, Australia.
Bonar
S Fiona
SF
Kirsh
George
G
Walter
William K
WK
Walter
William L
WL
D000328:Adult; D000537:Aluminum Oxide; D019644:Arthroplasty, Replacement, Hip; D002516:Ceramics; D005260:Female; D006621:Hip Joint / Q000503:physiopathology*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000175:diagnosis* / Q000209:etiology*; D016059:Range of Motion, Articular / Q000502:physiology; D014025:Titanium
D014025:Titanium; D000537:Aluminum Oxide