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Published in: Archives of Orthopaedic and Trauma Surgery 9/2009

01-09-2009 | Orthopaedic Surgery

Extremely high fracture rate of a modular acetabular component with a sandwich polyethylene ceramic insertion for THA: a preliminary report

Authors: Jörn Kircher, Rainer Bader, Bettina Schroeder, Wolfram Mittelmeier

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2009

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Abstract

Improvements of ceramic components and design changes have reduced failure rates over the past 30 years in total hip arthroplasty. We present a series of n = 11 cases with ceramic failure out of n = 113 implantations, from which n = 66 were ceramic-on-ceramic (n = 50 with ceramic insert with sandwich in polyethylene and n = 16 with directly fixed ceramic inlay) and n = 47 ceramic on polyethylene bearings, between 1999 and 2001 after introduction of a new implantation system to the market. The overall fracture rate of ceramic for the whole series (n = 113) was 9.7%. For the combination ceramic head with UHMW-PE (n = 47) the fracture rate was 2.1%. For the combination ceramic with ceramic (n = 66) the fracture rate was 15.2%. For the combination ceramic with ceramic sandwich in PE (n = 50) the failure rate was 18%. Only three patients experienced a trauma. Demography of patients (age, gender, body weight and BMI) was not statistically different between patients with failed ceramics and the rest of the patients making patient-specific risk factors unlikely to be an explanation for the failures. Retrospective X-ray analysis of the cup positioning did not show significant difference between failed and non-failed implants in terms of mean cup inclination and version making also operation-specific factors unlikely to be the only reason of this high failure rate. Therefore, manufacturer-specific factors such as design features may have contributed to this high failure rate. Further analysis of the whole series with biomechanical testing of the retrieved material needs to be performed.
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Metadata
Title
Extremely high fracture rate of a modular acetabular component with a sandwich polyethylene ceramic insertion for THA: a preliminary report
Authors
Jörn Kircher
Rainer Bader
Bettina Schroeder
Wolfram Mittelmeier
Publication date
01-09-2009
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 9/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-008-0662-2

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