Ceramic-on-Ceramic Bearings in Hip Arthroplasty: A Clinical Review
Fixation of prosthetic implants is vital, and failure from loosening needs to be avoided if possible. Cement fixation is improving with advanced insertion techniques, but long-term use of cement beyond 10 years is still a worry. To compound the worries, polythene wear will cause periprosthetic osteolysis from debris disease. Fixation using the physiological process of bony integration of synthetic hydroxyapatite (HA) will obviate the use of cement. An HA-coated implant will become integrated and thereby fixed in cancellous bone. It is postulated that stem cells in the bone marrow will adhere to the HA coating and then become osteocytes, thereby fixing the implant.
Fixation may outlast the bearing surfaces. With over 20 years experience, results from HA fixation suggest that it is a reliable system, but we know that polythene bearings continue to wear and need isolated revision.
KeywordsAseptic Loosening Polythene Wear Bearing Surface Periprosthetic Osteolysis Synthetic Hydroxyapatite
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