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Ceramic femoral head fracture with massive metallosis and severe wear of the cone: a case report and review of the literature

Fracture de tête fémorale en céramique avec métallose massive

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Abstract

A case of a fractured ceramic femoral head without subsequent trauma, 14 months after a primary total hip arthroplasty, in a 40-year-old woman with hip dysplasia is reported. Intraoperative findings were multifragment femoral head and a damaged polyethylene insert along with diffuse metallosis and excessive wear of the cone of the stem. Both the stem and the acetabular component were stable. After the removal of ceramic fragments, metallotic tissue excision and careful lavage of the joint, the inlay was replaced by a similar one and a cobalt–chromium femoral head was placed to the existing notched taper of the firmly incorporated stem. At 22-month follow-up examination, the patient had no pain, used no walking aids and had normal activity.

Résumé

Nous rapportons un cas de fracture de tête céramique survenue sans notion traumatique 14 mois après une arthroplastie totale de hanche de première intention pour dysplasie chez une jeune femme de 40 ans. L’exploration per-opératoire a mis en évidence une fracture multifragmentaire de la tête, un insert polyéthylène endommagé, une métallose diffuse et une usure du cône métallique. La tige et l’implant acétabulaire étaient stables. Après ablation des fragments de céramique, excision de la métallose, et un lavage soigneux de l’articulation, un insert du même type a été mis en place et une tête métallique placée sur le cône de la tige. Au recul de 22 mois le patient est asymptomatique, marche sans canne et mène une activité normale.

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References

  1. Allain J, Goutallier D, Voisin MC, Lemouel S (1998) Failure of a stainless steel femoral head of a revision total hip arthroplasty performed after a fracture of a ceramic femoral head. A case report. J Bone Joint Surg 80-A:1355–1360

    Google Scholar 

  2. Allain J, Roudot-Thoraval F, Delecrin J, Anract P, Migaud H, Goutalier D (2003) Revision total hip arthroplasty performed after fracture of a ceramic femoral head. J Bone Joint Surg 85-A:825–830

    PubMed  Google Scholar 

  3. Arenas A, Tejero A, Garbayo A, Arias C, Barbadillo J, Lecumberri J (1999) Ceramic femoral head fractures in total hip replacement. Int Orthop 23:351–352

    Article  PubMed  CAS  Google Scholar 

  4. Burckhardt A, Berberat C (1993) How safe are ceramic heads as hip endoprostheses? A series of three head fractures within 3 months. Arch Orthop Trauma Surg 112:215–219

    Article  PubMed  CAS  Google Scholar 

  5. Callaway GH, Flynn W, Ranawat CS, Sculco TP (1995) Fracture of the femoral head after ceramic-on-polyethylene total hip arthroplasty. J Arthroplasty 10:855–859

    Article  PubMed  CAS  Google Scholar 

  6. Connes H (2003) Des déclarations à la matériovigilance aux décisions de la CNM. Revue de Chirurgie Orthopédique 89:49

    Google Scholar 

  7. Dambreville A (2003) Conduite chirurgicale pratique proposée aux chirurgiens confrontés au problème. Revue de Chirurgie Orthopédique 89:51

    Google Scholar 

  8. Davidson JA (1993) Characteristics of metal and ceramic total hip bearing surfaces and their effect on long-term ultra high molecular weight polyethylene wear. Clin Orthop 294:361–378

    PubMed  Google Scholar 

  9. Fritsch E, Gleitz M (1996) Ceramic femoral head fractures in total hip arthroplasty. Clin Orthop 328:129–136

    Article  PubMed  Google Scholar 

  10. Hannouche D, Nich C, Bizot P, Meunier A, Nizard R, Sedel L (2003) Fractures of ceramic bearings. Clin Orthop 417:19–26

    PubMed  Google Scholar 

  11. Higuchi F, Shiba N, Inoue A, Wakebe I (1995) Fracture of an alumina ceramic head in total hip arthroplasty. J Arthroplasty 10:851–854

    Article  PubMed  CAS  Google Scholar 

  12. Holmer P, Nielsen PT (1993) Fracture of a ceramic femoral head in total hip arthroplasty. J Arthroplasty 8:567–571

    Article  PubMed  CAS  Google Scholar 

  13. Kempf I, Semlitsch M (1990) Massive wear of a steel ball head by ceramic fragments in the polyethylene acetabular cup after revision of a total hip prosthesis with fractured ceramic ball. Arch Orthop Trauma Surg 109:284–287

    Article  PubMed  CAS  Google Scholar 

  14. Krikler S, Schatzker J (1995) Ceramic head failure. J Arthroplasty 10:860–862

    Article  PubMed  CAS  Google Scholar 

  15. Mangione P, Pascarel X, Vinciguerra B, Honton JL (1994) Fracture of the ceramic head in total hip prosthesis. Apropos of 2 cases. Int Orthop 18:359–362

    Article  PubMed  CAS  Google Scholar 

  16. Matziolis G, Perka C, Dish A (2003) Massive metallosis after revision of a fractured ceramic head onto a metal head. Arch Orthop Trauma Surg 123:48–50

    PubMed  Google Scholar 

  17. McLean CR, Dabis H, Mok D (2002) Delayed fracture of the ceramic femoral head after trauma. J Arthroplasty 17:503–504

    Article  PubMed  CAS  Google Scholar 

  18. Michaud RJ, Rashad SY (1995) Spontaneous fracture of the ceramic ball in a ceramic–polyethylene total arthroplasty. J Arthroplasty 10:863–867

    Article  PubMed  CAS  Google Scholar 

  19. Moreschini O, Braidotti P (1991) Traumatic breakage of the ceramic head of prosthesis in total hip replacement. Ital J Orthop Traumatol 17:339–343

    PubMed  CAS  Google Scholar 

  20. Nizard RS, Sedel L, Christel P, Meunier A, Soudry M, Witvoet J (1992) Ten-year survivorship of cemented ceramic–ceramic total hip prosthesis. Clin Orthop 282:53–63

    PubMed  Google Scholar 

  21. Otsuka NY, Schatzker J (1994) A case of fracture of a ceramic head in total hip arthroplasty. Arch Orthop Trauma Surg 113:81–82

    Article  PubMed  CAS  Google Scholar 

  22. Peiro A, Pardo J, Navarrete R, Rodríguez-Alonso L, Martos F (1991) Fracture of the ceramic head in total hip arthroplasty. Report of two cases. J Arthroplasty 6:371–374

    Article  PubMed  CAS  Google Scholar 

  23. Piconi C, Labanti M, Magnani G, Caporale M, Maccauro G, Magliocchetti G (1999) Analysis of a failed alumina THR ball head. Biomaterials 20:1637–1646

    Article  PubMed  CAS  Google Scholar 

  24. Pulliam I, Trousdale R (1997) Fracture of a ceramic femoral head after a revision operation. J Bone Joint Surg 79-A:118–121

    PubMed  CAS  Google Scholar 

  25. Wenda K, Ritter G, Rudig L (1993) Therapy of burst ceramic head of a hip prosthesis. Aktuelle Traumatol 23:294–296

    PubMed  CAS  Google Scholar 

  26. Willmann G (2000) Ceramic femoral head retrieval data. Clin Orthop 379:22–28

    Article  PubMed  Google Scholar 

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Panagopoulos, A., Megas, P., Tyllianakis, M. et al. Ceramic femoral head fracture with massive metallosis and severe wear of the cone: a case report and review of the literature. Eur J Orthop Surg Traumatol 16, 55–59 (2006). https://doi.org/10.1007/s00590-005-0025-4

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  • DOI: https://doi.org/10.1007/s00590-005-0025-4

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