Ceramic-on-ceramic vs. metal-on-metal in total hip arthroplasty (THA): do 36-mm diameters exhibit comparable wear performance?

2009 ◽  
Vol 40 (1-2) ◽  
pp. 94-97 ◽  
Author(s):  
M. Spinelli ◽  
S. Affatato ◽  
A. Corvi ◽  
M. Viceconti
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Wear Performance ◽  
Total Hip ◽  
Metal On Metal ◽  
Ceramic On Ceramic

scholarly journals The influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty

2021 ◽  
Vol 32 (9) ◽  
Author(s):  
Francesco Castagnini ◽  
Barbara Bordini ◽  
Monica Cosentino ◽  
Cristina Ancarani ◽  
Federica Mariotti ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lower Risk ◽  
Time Distribution ◽  
Total Hip ◽  
Arthroplasty Registry ◽  
Metal On Metal ◽  
The Impact ◽  
Frequent Reason ◽  
Ceramic On Ceramic

Abstract Introduction Recurrent dislocations are still the most frequent reason for revision in total hip arthroplasty (THA). The impact of bearing surfaces on dislocations is still controversial. We hypothesized that: (1) bearing surfaces influence the revisions due to dislocations; (2) ceramic-on-ceramic reduced the revisions for dislocations in adjusted models; (3) Delta-on-Delta bearings reduced the revisions for dislocations in comparison to surfaces with cross-linked polyethylene. Materials and methods The regional arthroplasty registry was enquired about bearing surfaces and revisions for dislocations and instability. Unadjusted and adjusted rates were provided, including sex, age (<65 years or ≥65 years), head diameter (≤28 mm or >28 mm; <36 mm or ≥36 mm) as variables. 44,065 THAs were included. Results The rate of revisions for dislocations was significantly lower in ceramic-on-ceramic and metal-on-metal bearings (unadjusted rates). After adjusting for age, sex, and head size (36 and 28 mm), hard-on-hard bearings were protective (p < 0.05): ceramic-on-ceramic had a lower risk of revisions due to dislocation than ceramic-on-polyethylene (HR 1.6, 95% CI 1.2–2.2 p = 0.0009). The rate of revisions for dislocation was similar in bearings with cross-linked polyethylene and Delta-on-Delta articulations, in unadjusted and adjusted models. Conclusion Bearings with conventional polyethylene were more predisposed to dislocations. Currently adopted bearings exerted no significant influence on revisions due to dislocations. These findings could be primarily related to wear, but due to the time distribution, soft tissue envelopes and surface tension may also play a role. Pre-clinical biomechanical evaluations and prospective matched cohort studies are required to draw definitive conclusions.

scholarly journals Serum ion levels after ceramic-on-ceramic and metal-on-metal total hip arthroplasty: 8-year minimum follow-up

2008 ◽  
Vol 26 (12) ◽  
pp. 1569-1576 ◽  
Author(s):  
Lucia Savarino ◽  
Giovanni Padovani ◽  
Massimo Ferretti ◽  
Michelina Greco ◽  
Elisabetta Cenni ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Metal On Metal ◽  
Ceramic On Ceramic

Wear of different materials for total hip replacement under adverse stop-dwell-start in vitro wear simulation conditions

2018 ◽  
Vol 232 (12) ◽  
pp. 1261-1270 ◽  
Author(s):  
Megan Hadley ◽  
Catherine Hardaker ◽  
Graham Isaac ◽  
John Fisher
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Activity Cycle ◽  
Relative Increase ◽  
Total Hip ◽  
Metal On Metal ◽  
Metal Metal ◽  
The Impact ◽  
Ceramic On Ceramic

Hip simulation is a common technique for pre-clinical evaluation of wear performance of total hip arthroplasty. Standard techniques replicate kinematics of walking patterns of a typical patient. Attention has focussed in developing simulations of other typical patient daily activities to improve accuracy of wear predictions. A method for simulating stop-dwell-start motion during patient walking and the effect on 36-mm metal-on-metal total hip arthroplasty was previously presented by the authors. This study sought to extend the previous work to look at the effect of these conditions on ceramic-on-ceramic, metal-on-polyethylene and ceramic-on-polyethylene bearings. Two stop-dwell-start protocols were used: one reproducing average patient movement patterns and one examining more severe conditions. For all materials tested, no significant increase in wear was observed under average stop-dwell-start conditions, suggesting the bearing types tested are robust to this type of activity. A significant increase in wear was observed for metal-on-metal, metal-on-polyethylene and ceramic-on-polyethylene bearings under severe stop-dwell-start conditions, this was attributed to depletion of lubricant in the bearing during the dwell period. A greater relative increase in wear was observed for metal-on-metal bearings compared with metal-on-polyethylene and ceramic-on-polyethylene bearings. This may be explained by the contributions of the different lubrication mechanisms in each bearing type. Wear of ceramic-on-ceramic was very low in all tests, suggesting normal measurement variation was masking any effect of the adverse conditions. It was not possible to determine any effect of the different activities. These results emphasise the importance of exploring adverse patient activity simulations. The increase in wear rate associated with an adverse activity such as seen in stop-dwell-start motion, has to be considered in the context of the frequency of the adverse activity cycle relative to other activities such as standard continuous walking, to determine the impact on the total wear in a given time period.

scholarly journals Fatal Cobalt Toxicity after a Non-Metal-on-Metal Total Hip Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Rinne M. Peters ◽  
Pax Willemse ◽  
Paul C. Rijk ◽  
Mels Hoogendoorn ◽  
Wierd P. Zijlstra
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
X Rays ◽  
Total Hip ◽  
Metal On Metal ◽  
Metal Wear ◽  
Cobalt Toxicity ◽  
Ceramic On Ceramic

This case illustrates the potential for systemic cobalt toxicity in non-metal-on-metal bearings and its potentially devastating consequences. We present a 71-year-old male with grinding sensations in his right hip following ceramic-on-ceramic total hip arthroplasty (THA). After diagnosing a fractured ceramic liner, the hip prosthesis was revised into a metal-on-polyethylene bearing. At one year postoperatively, X-rays and MARS-MRI showed a fixed reversed hybrid THA, with periarticular densities, flattening of the femoral head component, and a pattern of periarticular metal wear debris and pseudotumor formation. Before revision could take place, the patient was admitted with the clinical picture of systemic cobalt toxicity, supported by excessively high serum cobalt and chromium levels, and ultimately died. At autopsy dilated cardiomyopathy as cause of death was hypothesized. A third body wear reaction between ceramic remnants and the metal femoral head very likely led to excessive metal wear, which contributed systemic cobalt toxicity leading to neurotoxicity and heart failure. This case emphasizes that fractured ceramic-on-ceramic bearings should be revised to ceramic-on-ceramic or ceramic-on-polyethylene bearings, but not to metal-on-polyethylene bearings. We aim to increase awareness among orthopedic surgeons for clinical clues for systemic cobalt intoxication, even when there is no metal-on-metal bearing surface.

Metal on Metal or Ceramic on Ceramic for Cementless Total Hip Arthroplasty: A Meta-Analysis

2016 ◽  
Vol 31 (11) ◽  
pp. 2637-2645.e1 ◽  
Author(s):  
Young-Kyun Lee ◽  
Byung-Ho Yoon ◽  
Yun Seong Choi ◽  
Woo-Lam Jo ◽  
Yong-Chan Ha ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Metal On Metal ◽  
Ceramic On Ceramic
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