Skip to main content
Top
Published in: International Orthopaedics 2/2011

01-02-2011 | Review Article

Thirty years of experience with alumina-on-alumina bearings in total hip arthroplasty

Authors: Didier Hannouche, Amine Zaoui, Frédéric Zadegan, Laurent Sedel, Rémy Nizard

Published in: International Orthopaedics | Issue 2/2011

Login to get access

Abstract

Alumina-on-alumina bearings in total hip arthroplasty have been developed in an attempt to minimise debris and the occurrence of osteolytic lesions. The outstanding tribological properties of this bearing system are explained by low surface roughness, high hardness for major scratch resistance, and high wettability. Since the 1970s, technological improvements in the manufacturing process of alumina components together with a better understanding of Morse taper technology have provided a surgical grade material with high density, high purity and small grains. Published studies on the outcome of total hip arthroplasty performed with this new generation of implants showed high survivorship especially in young and active patients, with survival rates free of revision of 90.8% to 97.4% at ten years. However, concern remains over ceramic liner fracture and squeaking, which has been noted recently with increasing prevalence. This review will discuss the current knowledge on the use of alumina-on-alumina bearings.
Literature
1.
go back to reference Boutin P (1971) Alumina and its use in surgery of the hip. (Experimental study). Presse Méd 79:639–640PubMed Boutin P (1971) Alumina and its use in surgery of the hip. (Experimental study). Presse Méd 79:639–640PubMed
2.
go back to reference Hannouche D, Nich C, Bizot P, Meunier A, Nizard R, Sedel L (2003) Fractures of ceramic bearings: history and present status. Clin Orthop Relat Res 19–26 Hannouche D, Nich C, Bizot P, Meunier A, Nizard R, Sedel L (2003) Fractures of ceramic bearings: history and present status. Clin Orthop Relat Res 19–26
3.
go back to reference 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 53–63 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 53–63
4.
go back to reference Bizot P, Banallec L, Sedel L, Nizard R (2000) Alumina-on-alumina total hip prostheses in patients 40 years of age or younger. Clin Orthop Relat Res 68–76 Bizot P, Banallec L, Sedel L, Nizard R (2000) Alumina-on-alumina total hip prostheses in patients 40 years of age or younger. Clin Orthop Relat Res 68–76
5.
go back to reference Hamadouche M, Nizard RS, Meunier A, Bizot P, Sedel L (1999) Cementless bulk alumina socket: preliminary results at 6 years. J Arthroplasty 14:701–707CrossRefPubMed Hamadouche M, Nizard RS, Meunier A, Bizot P, Sedel L (1999) Cementless bulk alumina socket: preliminary results at 6 years. J Arthroplasty 14:701–707CrossRefPubMed
6.
go back to reference Bizot P, Larrouy M, Witvoet J, Sedel L, Nizard R (2000) Press-fit metal-backed alumina sockets: a minimum 5-year followup study. Clin Orthop Relat Res 134–142 Bizot P, Larrouy M, Witvoet J, Sedel L, Nizard R (2000) Press-fit metal-backed alumina sockets: a minimum 5-year followup study. Clin Orthop Relat Res 134–142
7.
go back to reference Garcia-Rey E, Cruz-Pardos A, Garcia-Cimbrelo E (2009) Alumina-on-alumina total hip arthroplasty in young patients: diagnosis is more important than age. Clin Orthop Relat Res 467:2281–2289CrossRefPubMed Garcia-Rey E, Cruz-Pardos A, Garcia-Cimbrelo E (2009) Alumina-on-alumina total hip arthroplasty in young patients: diagnosis is more important than age. Clin Orthop Relat Res 467:2281–2289CrossRefPubMed
8.
go back to reference Bascarevic Z, Vukasinovic Z, Slavkovic N, Dulic B, Trajkovic G, Bascarevic V, Timotijevic S (2010) Alumina-on-alumina ceramic versus metal-on-highly cross-linked polyethylene bearings in total hip arthroplasty: a comparative study. Int Orthop 34:1129–1135CrossRefPubMed Bascarevic Z, Vukasinovic Z, Slavkovic N, Dulic B, Trajkovic G, Bascarevic V, Timotijevic S (2010) Alumina-on-alumina ceramic versus metal-on-highly cross-linked polyethylene bearings in total hip arthroplasty: a comparative study. Int Orthop 34:1129–1135CrossRefPubMed
9.
go back to reference Ha YC, Kim SY, Kim HJ, Yoo JJ, Koo KH (2007) Ceramic liner fracture after cementless alumina-on-alumina total hip arthroplasty. Clin Orthop Relat Res 458:106–110PubMed Ha YC, Kim SY, Kim HJ, Yoo JJ, Koo KH (2007) Ceramic liner fracture after cementless alumina-on-alumina total hip arthroplasty. Clin Orthop Relat Res 458:106–110PubMed
10.
go back to reference Ranawat AS, Ranawat CS (2007) The squeaking hip: a cause for concern-agrees. Orthopedics 30(738):743 Ranawat AS, Ranawat CS (2007) The squeaking hip: a cause for concern-agrees. Orthopedics 30(738):743
11.
go back to reference Walter WL, Waters TS, Gillies M, Donohoo S, Kurtz SM, Ranawat AS, Hozack WJ, Tuke MA (2008) Squeaking hips. J Bone Joint Surg Am 90(Suppl 4):102–111CrossRefPubMed Walter WL, Waters TS, Gillies M, Donohoo S, Kurtz SM, Ranawat AS, Hozack WJ, Tuke MA (2008) Squeaking hips. J Bone Joint Surg Am 90(Suppl 4):102–111CrossRefPubMed
12.
go back to reference Jarrett CA, Ranawat AS, Bruzzone M, Blum YC, Rodriguez JA, Ranawat CS (2009) The squeaking hip: a phenomenon of ceramic-on-ceramic total hip arthroplasty. J Bone Joint Surg Am 91:1344–1349CrossRefPubMed Jarrett CA, Ranawat AS, Bruzzone M, Blum YC, Rodriguez JA, Ranawat CS (2009) The squeaking hip: a phenomenon of ceramic-on-ceramic total hip arthroplasty. J Bone Joint Surg Am 91:1344–1349CrossRefPubMed
13.
go back to reference Hannouche D, Hamadouche M, Nizard R, Bizot P, Meunier A, Sedel L (2005) Ceramics in total hip replacement. Clin Orthop Relat Res 62–71 Hannouche D, Hamadouche M, Nizard R, Bizot P, Meunier A, Sedel L (2005) Ceramics in total hip replacement. Clin Orthop Relat Res 62–71
14.
go back to reference Christel PS (1992) Biocompatibility of surgical-grade dense polycrystalline alumina. Clin Orthop 10–18 Christel PS (1992) Biocompatibility of surgical-grade dense polycrystalline alumina. Clin Orthop 10–18
15.
go back to reference Hoffinger SA, Keggi KJ, Zatorski LE (1991) Primary ceramic hip replacement: a prospective study of 119 hips. Orthopedics 14:523–531PubMed Hoffinger SA, Keggi KJ, Zatorski LE (1991) Primary ceramic hip replacement: a prospective study of 119 hips. Orthopedics 14:523–531PubMed
16.
go back to reference Mittelmeier H, Heisel J (1992) Sixteen-years' experience with ceramic hip prostheses. Clin Orthop 64–72 Mittelmeier H, Heisel J (1992) Sixteen-years' experience with ceramic hip prostheses. Clin Orthop 64–72
17.
go back to reference Walter IA (1992) On the material and tribology of alumina-alumina couplings for hip joint prostheses. Clin Orthop 282:31–46PubMed Walter IA (1992) On the material and tribology of alumina-alumina couplings for hip joint prostheses. Clin Orthop 282:31–46PubMed
18.
go back to reference Boutin P, Christel P, Dorlot JM, Meunier A, de Roquancourt A, Blanquaert D, Herman S, Sedel L, Witvoet J (1988) The use of dense alumina-alumina ceramic combination in total hip replacement. J Biomed Mater Res 22:1203–1232CrossRefPubMed Boutin P, Christel P, Dorlot JM, Meunier A, de Roquancourt A, Blanquaert D, Herman S, Sedel L, Witvoet J (1988) The use of dense alumina-alumina ceramic combination in total hip replacement. J Biomed Mater Res 22:1203–1232CrossRefPubMed
19.
go back to reference Clarke IC, Good V, Williams P, Schroeder D, Anissian L, Stark A, Oonishi H, Schuldies J, Gustafson G (2000) Ultra-low wear rates for rigid-on-rigid bearings in total hip replacements. Proc Inst Mech Eng H 214:331–347CrossRefPubMed Clarke IC, Good V, Williams P, Schroeder D, Anissian L, Stark A, Oonishi H, Schuldies J, Gustafson G (2000) Ultra-low wear rates for rigid-on-rigid bearings in total hip replacements. Proc Inst Mech Eng H 214:331–347CrossRefPubMed
20.
go back to reference Prudhommeaux F, Hamadouche M, Nevelos J, Doyle C, Meunier A, Sedel L (2000) Wear of alumina-on-alumina total hip arthroplasties at a mean 11-year followup. Clin Orthop Relat Res 113–122 Prudhommeaux F, Hamadouche M, Nevelos J, Doyle C, Meunier A, Sedel L (2000) Wear of alumina-on-alumina total hip arthroplasties at a mean 11-year followup. Clin Orthop Relat Res 113–122
21.
go back to reference Petit A, Catelas I, Antoniou J, Zukor DJ, Huk OL (2002) Differential apoptotic response of J774 macrophages to alumina and ultra-high-molecular-weight polyethylene particles. J Orthop Res 20:9–15CrossRefPubMed Petit A, Catelas I, Antoniou J, Zukor DJ, Huk OL (2002) Differential apoptotic response of J774 macrophages to alumina and ultra-high-molecular-weight polyethylene particles. J Orthop Res 20:9–15CrossRefPubMed
22.
go back to reference Catelas I, Petit A, Zukor DJ, Marchand R, Yahia L, Huk OL (1999) Induction of macrophage apoptosis by ceramic and polyethylene particles in vitro. Biomaterials 20:625–630CrossRefPubMed Catelas I, Petit A, Zukor DJ, Marchand R, Yahia L, Huk OL (1999) Induction of macrophage apoptosis by ceramic and polyethylene particles in vitro. Biomaterials 20:625–630CrossRefPubMed
23.
go back to reference Hamadouche M, Boutin P, Daussange J, Bolander ME, Sedel L (2002) Alumina-on-alumina total hip arthroplasty: a minimum 18.5-year follow-up study. J Bone Joint Surg Am 84-A:69–77PubMed Hamadouche M, Boutin P, Daussange J, Bolander ME, Sedel L (2002) Alumina-on-alumina total hip arthroplasty: a minimum 18.5-year follow-up study. J Bone Joint Surg Am 84-A:69–77PubMed
24.
go back to reference Bizot P, Hannouche D, Nizard R, Witvoet J, Sedel L (2004) Hybrid alumina total hip arthroplasty using a press-fit metal-backed socket in patients younger than 55 years. A six- to 11-year evaluation. J Bone Joint Surg Br 86:190–194CrossRefPubMed Bizot P, Hannouche D, Nizard R, Witvoet J, Sedel L (2004) Hybrid alumina total hip arthroplasty using a press-fit metal-backed socket in patients younger than 55 years. A six- to 11-year evaluation. J Bone Joint Surg Br 86:190–194CrossRefPubMed
25.
go back to reference Petsatodis GE, Papadopoulos PP, Papavasiliou KA, Hatzokos IG, Agathangelidis FG, Christodoulou AG (2010) Primary cementless total hip arthroplasty with an alumina ceramic-on-ceramic bearing: results after a minimum of twenty years of follow-up. J Bone Joint Surg Am 92:639–644CrossRefPubMed Petsatodis GE, Papadopoulos PP, Papavasiliou KA, Hatzokos IG, Agathangelidis FG, Christodoulou AG (2010) Primary cementless total hip arthroplasty with an alumina ceramic-on-ceramic bearing: results after a minimum of twenty years of follow-up. J Bone Joint Surg Am 92:639–644CrossRefPubMed
26.
go back to reference Kress AM, Schmidt R, Holzwarth U, Forst R, Mueller LA (2010) Excellent results with cementless total hip arthroplasty and alumina-on-alumina pairing: minimum ten-year follow-up. Int Orthop. doi:10.1007/s00264-010-1150-1 Kress AM, Schmidt R, Holzwarth U, Forst R, Mueller LA (2010) Excellent results with cementless total hip arthroplasty and alumina-on-alumina pairing: minimum ten-year follow-up. Int Orthop. doi:10.​1007/​s00264-010-1150-1
27.
go back to reference Bohler M, Mochida Y, Bauer TW, Plenk H Jr, Salzer M (2000) Wear debris from two different alumina-on-alumina total hip arthroplasties. J Bone Joint Surg Br 82:901–909CrossRefPubMed Bohler M, Mochida Y, Bauer TW, Plenk H Jr, Salzer M (2000) Wear debris from two different alumina-on-alumina total hip arthroplasties. J Bone Joint Surg Br 82:901–909CrossRefPubMed
28.
go back to reference Brown C, Williams S, Tipper JL, Fisher J, Ingham E (2007) Characterisation of wear particles produced by metal on metal and ceramic on metal hip prostheses under standard and microseparation simulation. J Mater Sci Mater Med 18:819–827CrossRefPubMed Brown C, Williams S, Tipper JL, Fisher J, Ingham E (2007) Characterisation of wear particles produced by metal on metal and ceramic on metal hip prostheses under standard and microseparation simulation. J Mater Sci Mater Med 18:819–827CrossRefPubMed
29.
go back to reference Fye MA, Huo MH, Zatorski LE, Keggi KJ (1998) Total hip arthroplasty performed without cement in patients with femoral head osteonecrosis who are less than 50 years old. J Arthroplasty 13:876–881CrossRefPubMed Fye MA, Huo MH, Zatorski LE, Keggi KJ (1998) Total hip arthroplasty performed without cement in patients with femoral head osteonecrosis who are less than 50 years old. J Arthroplasty 13:876–881CrossRefPubMed
30.
go back to reference Gualtieri G, Nigrisoli M, Dallari D, Catamo L, Gualtieri I (1993) A study of the mechanical and biological behavior of bioceramic hip arthroplasty followed-up after more than 10 years. Chir Organi Mov 78:213–222PubMed Gualtieri G, Nigrisoli M, Dallari D, Catamo L, Gualtieri I (1993) A study of the mechanical and biological behavior of bioceramic hip arthroplasty followed-up after more than 10 years. Chir Organi Mov 78:213–222PubMed
31.
go back to reference Huo MH, Martin RP, Zatorski LE, Keggi KJ (1995) Ceramic total hip replacement done without cement. Long term follow-up study. Orthop Trans 19:400–401 Huo MH, Martin RP, Zatorski LE, Keggi KJ (1995) Ceramic total hip replacement done without cement. Long term follow-up study. Orthop Trans 19:400–401
32.
go back to reference Hernigou P, Zilber S, Filippini P, Poignard A (2009) Ceramic-ceramic bearing decreases osteolysis: a 20-year study versus ceramic-polyethylene on the contralateral hip. Clin Orthop Relat Res 467:2274–2280CrossRefPubMed Hernigou P, Zilber S, Filippini P, Poignard A (2009) Ceramic-ceramic bearing decreases osteolysis: a 20-year study versus ceramic-polyethylene on the contralateral hip. Clin Orthop Relat Res 467:2274–2280CrossRefPubMed
33.
go back to reference Ilchmann T, Neher S, Maurer F, Weise K (2007) Modes of failure of a threaded acetabular cup: a radiographic study with EBRA of 42 revised cups. Int Orthop 31:211–216CrossRefPubMed Ilchmann T, Neher S, Maurer F, Weise K (2007) Modes of failure of a threaded acetabular cup: a radiographic study with EBRA of 42 revised cups. Int Orthop 31:211–216CrossRefPubMed
34.
go back to reference Mochida Y, Boehler M, Salzer M, Bauer TW (2001) Debris from failed ceramic-on-ceramic and ceramic-on-polyethylene hip prostheses. Clin Orthop Relat Res 113–125 Mochida Y, Boehler M, Salzer M, Bauer TW (2001) Debris from failed ceramic-on-ceramic and ceramic-on-polyethylene hip prostheses. Clin Orthop Relat Res 113–125
35.
go back to reference Hatton A, Nevelos JE, Matthews JB, Fisher J, Ingham E (2003) Effects of clinically relevant alumina ceramic wear particles on TNF-alpha production by human peripheral blood mononuclear phagocytes. Biomaterials 24:1193–1204CrossRefPubMed Hatton A, Nevelos JE, Matthews JB, Fisher J, Ingham E (2003) Effects of clinically relevant alumina ceramic wear particles on TNF-alpha production by human peripheral blood mononuclear phagocytes. Biomaterials 24:1193–1204CrossRefPubMed
36.
go back to reference Willmann G (2000) Ceramic femoral head retrieval data. Clin Orthop Relat Res 379:22–28 Willmann G (2000) Ceramic femoral head retrieval data. Clin Orthop Relat Res 379:22–28
37.
go back to reference Heck DA, Partridge CM, Reuben JD, Lanzer WL, Lewis CG, Keating EM (1995) Prosthetic component failures in hip arthroplasty surgery. J Arthroplasty 10:575–580CrossRefPubMed Heck DA, Partridge CM, Reuben JD, Lanzer WL, Lewis CG, Keating EM (1995) Prosthetic component failures in hip arthroplasty surgery. J Arthroplasty 10:575–580CrossRefPubMed
38.
go back to reference 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 109:284–287CrossRefPubMed 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 109:284–287CrossRefPubMed
39.
go back to reference 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 Am 80:1355–1360CrossRefPubMed 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 Am 80:1355–1360CrossRefPubMed
40.
go back to reference Allain J, Roudot-Thoraval F, Delecrin J, Anract P, Migaud H, Goutallier D (2003) Revision total hip arthroplasty performed after fracture of a ceramic femoral head. A multicenter survivorship study. J Bone Joint Surg Am 85-A:825–830PubMed Allain J, Roudot-Thoraval F, Delecrin J, Anract P, Migaud H, Goutallier D (2003) Revision total hip arthroplasty performed after fracture of a ceramic femoral head. A multicenter survivorship study. J Bone Joint Surg Am 85-A:825–830PubMed
41.
go back to reference Sharma V, Ranawat AS, Rasquinha VJ, Weiskopf J, Howard H, Ranawat CS (2010) Revision total hip arthroplasty for ceramic head fracture: a long-term follow-up. J Arthroplasty 25:342–347CrossRefPubMed Sharma V, Ranawat AS, Rasquinha VJ, Weiskopf J, Howard H, Ranawat CS (2010) Revision total hip arthroplasty for ceramic head fracture: a long-term follow-up. J Arthroplasty 25:342–347CrossRefPubMed
42.
go back to reference Hannouche D, Delambre J, Zadegan F, Sedel L, Nizard R (2010) Is there a risk in placing a ceramic head on a previously implanted trunion? Clin Orthop Relat Res 468:3322–3327CrossRefPubMed Hannouche D, Delambre J, Zadegan F, Sedel L, Nizard R (2010) Is there a risk in placing a ceramic head on a previously implanted trunion? Clin Orthop Relat Res 468:3322–3327CrossRefPubMed
43.
go back to reference Baek SH, Kim SY (2008) Cementless total hip arthroplasty with alumina bearings in patients younger than fifty with femoral head osteonecrosis. J Bone Joint Surg Am 90:1314–1320CrossRefPubMed Baek SH, Kim SY (2008) Cementless total hip arthroplasty with alumina bearings in patients younger than fifty with femoral head osteonecrosis. J Bone Joint Surg Am 90:1314–1320CrossRefPubMed
44.
go back to reference Keurentjes JC, Kuipers RM, Wever DJ, Schreurs BW (2008) High incidence of squeaking in THAs with alumina ceramic-on-ceramic bearings. Clin Orthop Relat Res 466:1438–1443CrossRefPubMed Keurentjes JC, Kuipers RM, Wever DJ, Schreurs BW (2008) High incidence of squeaking in THAs with alumina ceramic-on-ceramic bearings. Clin Orthop Relat Res 466:1438–1443CrossRefPubMed
45.
go back to reference Schroder D, Bornstein L, Bostrom MP, Nestor BJ, Padgett DE, Westrich GH (2010) Ceramic-on-ceramic total hip arthroplasty: incidence of instability and noise. Clin Orthop Relat Res. Sep 18 [Epub ahead of print] Schroder D, Bornstein L, Bostrom MP, Nestor BJ, Padgett DE, Westrich GH (2010) Ceramic-on-ceramic total hip arthroplasty: incidence of instability and noise. Clin Orthop Relat Res. Sep 18 [Epub ahead of print]
46.
go back to reference Restrepo C, Matar WY, Parvizi J, Rothman RH, Hozack WJ (2010) Natural history of squeaking after total hip arthroplasty. Clin Orthop Relat Res 468:2340–2345CrossRefPubMed Restrepo C, Matar WY, Parvizi J, Rothman RH, Hozack WJ (2010) Natural history of squeaking after total hip arthroplasty. Clin Orthop Relat Res 468:2340–2345CrossRefPubMed
47.
go back to reference Taylor S, Manley MT, Sutton K (2007) The role of stripe wear in causing acoustic emissions from alumina ceramic-on-ceramic bearings. J Arthroplasty 22:47–51CrossRefPubMed Taylor S, Manley MT, Sutton K (2007) The role of stripe wear in causing acoustic emissions from alumina ceramic-on-ceramic bearings. J Arthroplasty 22:47–51CrossRefPubMed
48.
go back to reference Chevillotte C, Trousdale RT, Chen Q, Guyen O, An KN (2010) The 2009 Frank Stinchfield Award: “Hip squeaking”: a biomechanical study of ceramic-on-ceramic bearing surfaces. Clin Orthop Relat Res 468:345–350CrossRefPubMed Chevillotte C, Trousdale RT, Chen Q, Guyen O, An KN (2010) The 2009 Frank Stinchfield Award: “Hip squeaking”: a biomechanical study of ceramic-on-ceramic bearing surfaces. Clin Orthop Relat Res 468:345–350CrossRefPubMed
49.
go back to reference Walter WL, Insley GM, Walter WK, Tuke MA (2004) Edge loading in third generation alumina ceramic-on-ceramic bearings: stripe wear. J Arthroplasty 19:402–413CrossRefPubMed Walter WL, Insley GM, Walter WK, Tuke MA (2004) Edge loading in third generation alumina ceramic-on-ceramic bearings: stripe wear. J Arthroplasty 19:402–413CrossRefPubMed
50.
go back to reference Nevelos J, Ingham E, Doyle C, Streicher R, Nevelos A, Walter W, Fisher J (2000) Microseparation of the centers of alumina-alumina artificial hip joints during simulator testing produces clinically relevant wear rates and patterns. J Arthroplasty 15:793–795CrossRefPubMed Nevelos J, Ingham E, Doyle C, Streicher R, Nevelos A, Walter W, Fisher J (2000) Microseparation of the centers of alumina-alumina artificial hip joints during simulator testing produces clinically relevant wear rates and patterns. J Arthroplasty 15:793–795CrossRefPubMed
51.
go back to reference Restrepo C, Post ZD, Kai B, Hozack WJ (2010) The effect of stem design on the prevalence of squeaking following ceramic-on-ceramic bearing total hip arthroplasty. J Bone Joint Surg Am 92:550–557CrossRefPubMed Restrepo C, Post ZD, Kai B, Hozack WJ (2010) The effect of stem design on the prevalence of squeaking following ceramic-on-ceramic bearing total hip arthroplasty. J Bone Joint Surg Am 92:550–557CrossRefPubMed
52.
go back to reference Pulliam IT, Trousdale RT (1997) Fracture of a ceramic femoral head after a revision operation. A case report [see comments]. J Bone Joint Surg Am 79:118–121PubMed Pulliam IT, Trousdale RT (1997) Fracture of a ceramic femoral head after a revision operation. A case report [see comments]. J Bone Joint Surg Am 79:118–121PubMed
Metadata
Title
Thirty years of experience with alumina-on-alumina bearings in total hip arthroplasty
Authors
Didier Hannouche
Amine Zaoui
Frédéric Zadegan
Laurent Sedel
Rémy Nizard
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 2/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-010-1187-1

Other articles of this Issue 2/2011

International Orthopaedics 2/2011 Go to the issue