Metal-on-Polyethylene is Not an Option after the Fracture of a Ceramic Component of a Total Hip Arthroplasty

2016 ◽  
Vol 26 (6) ◽  
pp. e56-e56 ◽  
Author(s):  
Jenaro Á. Fernández-Valencia

Ceramic surfaces are commonly used in total hip arthroplasty (THA) in young patients due to their good tribological properties. Nonetheless, the fracture of ceramic components is among the most demanding complications of total hip arthroplasty. Ceramic failure is a matter of emergency and needs urgent revision arthroplasty. In this regard, the present study aimed to better understand how to diagnose a ceramic component fracture, identify the major risk factors for the fracture of ceramic components, and analyze the different techniques used in revision arthroplasty for ceramic bearing failure. The literature search was performed on PubMed, MEDLINE-Ovid, and Cochrane Reviews. The search keywords included ceramic fracture, ceramic failure, and ceramic arthroplasty revision surgery. A number of 47 articles were selected out of 126 articles found in the initial research. X-ray and computed tomography (CT) scan must be utilized on suspicion of ceramic component fracture. The most relevant risk factor for head fracture is short neck and 28-mm head combination. Moreover, acetabular cup malpositioning and liner misalignment during insertion are the two major risk factors for liner fracture. There is no consensus on the best revision treatment strategy. Nonetheless, it is necessary to perform a complete synovectomy and an accurate cleaning of the hip joint before the implant of the new components. Stability, integrity, and positioning of both femoral and acetabular components must be evaluated during surgery. If damaged, even well-fixed components should be removed. New ceramic bearing surface is the best option, whereas metal is not recommended for revision surgery.


2018 ◽  
Author(s):  
Benedikt Schwaiger ◽  
Alexandra Gersing ◽  
Daniela Muenzel ◽  
Julia Dangelmaier ◽  
Peter Prodinger ◽  
...  

1987 ◽  
Vol 58 (04) ◽  
pp. 1040-1042
Author(s):  
J J M L Hoffmann ◽  
J H J P M Kortmann

SummaryThe behaviour of the contact system was studied in 40 patients with total hip arthroplasty, by measuring plasma prekallikrein, spontaneous kallikrein activity and factor XII. In the literature it had been shown that patients with complications from this operation had decreased prekallikrein and increased kallikrein activity (M. Nakahara. Acta orthop scand 1982; 53: 591-6). In the present study, comprising patients with and without pain and proven loosening of the hip prosthesis, these findings could only partially be confirmed. Patients with a loosened prosthesis had significantly lower prekallikrein (mean 0.78 ± 0.28 U/ml; p <0.01) than patients without problems, but no detectable kallikrein activity in plasma. Patients with pain but no loosening had normal prekallikrein (1.04 ±0 0.26 U/ml) and also no demonstrable kallikrein activity. Factor XII was normal in all patient groups. It is concluded that decreased prekallikrein is limited to patients with a loosened hip prosthesis, with or without pain.


2020 ◽  
Vol 04 (02) ◽  
pp. 084-089
Author(s):  
Vivek Singh ◽  
Stephen Zak ◽  
Ran Schwarzkopf ◽  
Roy Davidovitch

AbstractMeasuring patient satisfaction and surgical outcomes following total joint arthroplasty remains controversial with most tools failing to account for both surgeon and patient satisfaction in regard to outcomes. The purpose of this study was to use “The Forgotten Joint Score” questionnaire to assess clinical outcomes comparing patients who underwent a total hip arthroplasty (THA) with those who underwent a total knee arthroplasty (TKA). We conducted a retrospective review of patients who underwent primary THA or TKA between September 2016 and September 2019 and responded to the Forgotten Joint Score-12 (FJS-12) questionnaire at least at one of three time periods (3, 12, and 21 months), postoperatively. An electronic patient rehabilitation application was used to administer the questionnaire. Collected variables included demographic data (age, gender, race, body mass index [BMI], and smoking status), length of stay (LOS), and FJS-12 scores. t-test and chi-square were used to determine significance. Linear regression was used to account for demographic differences. A p-value of less than 0.05 was considered statistically significant. Of the 2,359 patients included in this study, 1,469 underwent a THA and 890 underwent a TKA. Demographic differences were observed between the two groups with the TKA group being older, with higher BMI, higher American Society of Anesthesiologists scores, and longer LOS. Accounting for the differences in demographic data, THA patients consistently had higher scores at 3 months (53.72 vs. 24.96; p < 0.001), 12 months (66.00 vs. 43.57; p < 0.001), and 21 months (73.45 vs. 47.22; p < 0.001). FJS-12 scores for patients that underwent THA were significantly higher in comparison to TKA patients at 3, 12, and 21 months postoperatively. Increasing patient age led to a marginal increase in FJS-12 score in both cohorts. With higher FJS-12 scores, patients who underwent THA may experience a more positive evolution with their surgery postoperatively than those who had TKA.


Author(s):  
Johannes F. Plate ◽  
Kimona Issa ◽  
Craig Wright ◽  
Bartlomiej W. Szczech ◽  
Bhaveen H. Kapadia ◽  
...  

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