Fracture of ceramic heads in total hip replacement

  • B. Habermann
  • W. Ewald
  • M. Rauschmann
  • L. Zichner
  • A. A. Kurth
Orthopaedic Surgery

Abstract

After introduction of ceramics in total hip replacement, there have been several studies on wear and fracture of the femoral head component. Though reports on fractures are few, we saw four fractures within 2 months. In all patients, a cementless hip prosthesis by four different surgeons was implanted between 3/2001 and 2/2004. In three patients, a ceramic-on-polyethylene pair and in one, a ceramic-on-ceramic pair was used. Only one patient suffered an adequate trauma. The mean survival of the ceramic head was 27 months (11–42). In two patients with polyethylene inlays, the inlay showed signs of wear out due to the fractured head. All four revision surgeries had a good outcome with satisfying results and no complications. Though we observe the postoperative development after implantation of ceramic components closely, we still believe that ceramics in total hip replacement in young and active patients are indicated with good long term results.

Keywords

Total hip prosthesis Ceramic head fracture 

References

  1. 1.
    Allain J, Le Mouel S, Goutallier D, Voisin MC (1999) Poor eight-year survival of cemented zirconia-polyethylene total hip replacements. J Bone Joint Surg Br 81(5):835–842PubMedCrossRefGoogle Scholar
  2. 2.
    Barrack R:, Burak C, Skinner HB (2004) Concerns about ceramics in THA. Clin Orthop 429:73–79PubMedCrossRefGoogle Scholar
  3. 3.
    Bohler M, Mochida Y, Bauer TW, Plenk Jr H, Salzer M (2000) Wear debris from two different alumina-on-alumina total hip arthroplasties. J Bone Joint Surg 82B:901–909CrossRefGoogle Scholar
  4. 4.
    Borssen B, Kerrholm J, Snorrason F (1991) Osteolysis after ceramic-on-ceramic hip arthorplasty. A case report. Acta Orthop Scand 62(1):73–75Google Scholar
  5. 5.
    Boutin P (1972) Arthroplastie totale de hanche par prothèse en alumine frittée. Rev Chir Orthop 58:229–246PubMedGoogle Scholar
  6. 6.
    Boutin P, Blanquaert D (1981) Le frottement Al/Al en chirurgie de la hanche–1205 arthroplasties totales. Rev Chir Orthop; 279–287Google Scholar
  7. 7.
    Dawihl W, Dorre E, Altmeyer G (1980) Determination of the service life of a friction locking fixation element for use in ceramic total hips. Biomed Tech 25(12):311–315CrossRefGoogle Scholar
  8. 8.
    Dorre E, Dawihl W, Altmeyer G (1977) Fatigue strength of ceramic hip endoprostheses. Biomed Tech 22(1–2):3–7Google Scholar
  9. 9.
    Dorre E, Dawihl W, Krohn U, Altmeyer G, Semlithsc M (1982) Do ceramic components of artificial hip joints keep their strength in the human body? Biomed Tech 27(12): 303–308Google Scholar
  10. 10.
    Fritsch EW, Gleitz M (1996) Ceramic femoral head fractures in total hip arthoplasty. Clin Orthop 328:129–136PubMedCrossRefGoogle Scholar
  11. 11.
    Hannouche D, Hamadouche M, Nizard R, Bizot P, Meunier A, Sedel L (2005) Ceramics in total hip replacement. Clin Orhop Relat Res 430:62–71CrossRefGoogle Scholar
  12. 12.
    Harms J, Mausle E (1979) Tissue reaction to ceramic implant material. J Biomed Mater Res 13:67–87PubMedCrossRefGoogle Scholar
  13. 13.
    Heck DA, Partridge CM, Reuben JD et al. (1995) Prosthetic component failures in hip arthroplasty surgery. J Arthroplasty 10:575–580PubMedGoogle Scholar
  14. 14.
    Heck DA, Partridge CM, Reuben Jd, Lanzer WL, Lewis CG, Keating EM (1995) Prosthetic component failures in hip arthroplasty surgery. J Arthroplasty 10:575–580PubMedGoogle Scholar
  15. 15.
    Heisel J, Schmitt E (1987) Implant fractures in ceramic hip endoprostheses. Z Orthop 125:480–490CrossRefPubMedGoogle Scholar
  16. 16.
    Hummer CD, Rothmann RH, Hozack WJ (1995) Catastrophic failure of modular zirconia-ceramic femoral head components after total hip arthroplasty. J Arthroplasty 10(6):848–850PubMedCrossRefGoogle Scholar
  17. 17.
    Kern S, Schreiber A, Hilfiker B (1990) Ceramic head fracture—a rare complication in hip endoprosthesis. Case report and literature survey. Z Orthop Ihre Grenzgeb 128(5):543–548PubMedCrossRefGoogle Scholar
  18. 18.
    Kontinnen YT, Zhao D, Beklen A, Ma G et al (2005) The Microenvironment around total hip replacement prostheses. Clin Orthop Relat Res 430:28–38CrossRefGoogle Scholar
  19. 19.
    Maccauro G, Piconi C, Burger W, Pilloni L, De Santis E, Muratori F, Learmonth ID (2004) Fracture of a Y-TZP ceramic femoral head. J Bone Joint Surg Br 86-B:1192–1196CrossRefGoogle Scholar
  20. 20.
    Michaud RJ, Rasha SY (1995) Sontaneaous fracture of the ceramic ball in a ceramic-polyethylene total hip arthroplasty. J Arthroplasty 10(6):863–867PubMedCrossRefGoogle Scholar
  21. 21.
    Mittelmeier TH, Walter A (1987) The influence of prosthesis design on wear and loosening phenomena. CRC Crit Rev Biocompatibility 3:19Google Scholar
  22. 22.
    Norton MR, Yarlagadda R, Anderson GH (2002) Catastrophic failure of the Elite Plus total hip replacement, with a Hylamer acetabulum and Zirconia ceramic femoral head. J Bone Joint Surg Br 84(1):631–635PubMedCrossRefGoogle Scholar
  23. 23.
    Schwägerl W, Zenz P, Pospisil C, Gertschak W. (1995) Aspekte zur Zukunft der Hüftendoprothese an Hand von 10-Jahresergebnissen mit dem Zweymueller-Schaft und dem McKee-System. Die Metallpaarung „Metasul” in der Hüftendoprothetik. Huber, BernGoogle Scholar
  24. 24.
    Sedel L, Bizot P, Nizar R, Meunier A (1998) Perspective on a 25 years experience with ceramic on ceramic articulation in total hip replacement. Semin Arthroplasty 9:123–124Google Scholar
  25. 25.
    Sedel L (2000) Evolution of alumina-on-alumina implants. Clin Orthop Relat Res 379:48–54PubMedCrossRefGoogle Scholar
  26. 26.
    Simon JA, Dayan AJ, Ergas E et al (1998) Catastrophic failure of the acetabular component in a ceramic-polyethylene bearing total hip arthroplasty. J Arthroplasty 13:108–113PubMedCrossRefGoogle Scholar
  27. 27.
    Skinner HB (1999) Ceramic bearing surface. Clin Orthop 369:83–91PubMedCrossRefGoogle Scholar
  28. 28.
    Walter A (1997) Ceramic-to-ceramic combination. Relic or renaissance? Orthopade 26:110–116PubMedGoogle Scholar
  29. 29.
    Willman G (1998) Ceramics for total joint replacement—what a surgeon should know. Orthopedics 21:173–177Google Scholar
  30. 30.
    Willman G (2000) The evolution of ceramics in total hip replacement. Hip Int 10:193–203Google Scholar
  31. 31.
    Willmann G (2000) Ceramic femoral head retrieval data. Clin Orthop Relat Res 379:22–28PubMedCrossRefGoogle Scholar
  32. 32.
    Wirganowicz PZ, Thomas BJ (1997) Massive osteolysis after ceramic on ceramic total hip arthroplasty. A case report. Clin Orthop 338:100–104CrossRefGoogle Scholar
  33. 33.
    Wirganowicz PZ, Thomas BJ (1998) Massive osteolysis after ceramic on ceramic total hip arthroplasty. A case report. Clin Orthop Relat Res 349:273–274CrossRefGoogle Scholar
  34. 34.
    Wroblewski BM, Siney PD, Fleming PA (2003) Wear of enhanced ultra-high molecular-weight polyethylene (Hylamer) in comination with a 22.225 mm diameter zirconia fermoral head. J bone Joint Surg 85B:376–379CrossRefGoogle Scholar
  35. 35.
    Yoon TR, Rowe SM, Jung ST, Seon KJ, Maloney WJ (1998) Osteolysis in association with a total hip arthroplasty with ceramic bearing surfaces. J Bone Joint Surg Am 80(10):1459–1468PubMedGoogle Scholar
  36. 36.
    Zichner L, Willert HG (1992) Comparison of Alumina-Polyethylene and Metal-Polyethylene in Clinical Trials. Clin Orthop Relat Res 282:86–94PubMedGoogle Scholar
  37. 37.
    Zichner L, Lindenfeld T (1997) In-vivo wear of the slide combinations ceramics-polyethylene as opposed to metal-polyethylene. Orthopade 26:129–134PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • B. Habermann
    • 1
  • W. Ewald
    • 1
  • M. Rauschmann
    • 1
  • L. Zichner
    • 1
  • A. A. Kurth
    • 1
  1. 1.Department of Orthopaedic SurgeryUniversity Hospital Frankfurt/MainFrankfurt/MainGermany

Personalised recommendations