title: Survival of ceramic bearings in total hip replacement after high-energy trauma and periprosthetic acetabular fracture.
abstract: Surgeons remain concerned that ceramic hip prostheses may fail catastrophically if either the head or the liner is fractured. We report two patients, each with a ceramic-on-ceramic total hip replacement who sustained high-energy trauma sufficient to cause a displaced periprosthetic acetabular fracture in whom the ceramic bearings survived intact. Simultaneous fixation of the acetabular fracture, revision of the cementless acetabular prosthesis and exchange of the ceramic bearings were performed successfully in both patients. Improved methods of manufacture of new types of alumina ceramic with a smaller grain size, and lower porosity, have produced much stronger bearings. Whether patients should be advised to restrict high-impact activities in order to protect these modern ceramic bearings from fracture remains controversial.
authors.affiliation: Pelvic and Acetabular Reconstruction Unit, Department of Trauma and Orthopaedics, North Bristol NHS Trust, Frenchay Hospital, Bristol BS16 1LE, UK.
authors.forename: S
authors.initials: S
authors.lastname: Salih
authors.forename: V A
authors.initials: VA
authors.lastname: Currall
authors.forename: A J
authors.initials: AJ
authors.lastname: Ward
authors.forename: T J S
authors.initials: TJ
authors.lastname: Chesser
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries*; D000368:Aged; D000537:Aluminum Oxide; D019644:Arthroplasty, Replacement, Hip; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D011474:Prosthesis Design; D011859:Radiography
chemical_list: D000537:Aluminum Oxide