Revision Total Hip Arthroplasty for Fractured Ceramic Bearings: A Review of Best Practices for Revision Cases

Abstract Given that ceramics offer the lowest wear rates of all bearings for total hip arthroplasty (THA), their use has understandably increased especially among the young and more active population. Despite improvements to the manufacturing of these ceramic materials over the years, brittleness st...

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Bibliographic Details
Published inThe Journal of arthroplasty Vol. 32; no. 6; pp. 1959 - 1964
Main Authors Rambani, Rohit, MBBS, MS (Ortho), FIMSA, FRCS (Tr & Orth), Kepecs, David M., MSc, Mäkinen, Tatu J., MD, PhD, Safir, Oleg A., MD, MEd, Gross, Allan E., MD, Kuzyk, Paul R., MD, MASc
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.06.2017
Subjects
Aged
Arthroplasty, Replacement, Hip - methods
ceramic bearing
Ceramics - adverse effects
fracture
Fractures, Bone
Hip Prosthesis
Humans
Metals - chemistry
Middle Aged
Orthopedics
Osteotomy
Prosthesis Design
Prosthesis Failure
Reoperation - methods
revision
Risk Factors
Titanium - chemistry
total hip arthroplasty
Treatment Outcome
wear
wear
total hip arthroplasty
ceramic bearing
fracture
revision
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Summary:Abstract Given that ceramics offer the lowest wear rates of all bearings for total hip arthroplasty (THA), their use has understandably increased especially among the young and more active population. Despite improvements to the manufacturing of these ceramic materials over the years, brittleness still remains a concern. Ceramic fracture is rare (<1%) following THA, but increased utilization of this bearing surface has led to greater incidences of these events. In all revision cases, it is mandatory to perform a complete synovectomy and thorough debridement of the fractured ceramic fragments. A well fixed acetabular component should be removed if either the locking mechanism is damaged or the component is malpositioned. If the femoral stem taper is damaged, the femoral stem should be removed. However, if minimal damage is present, the femoral stem may be retained and revised using a fourth generation ceramic head with an integrated titanium sleeve. Metal bearings should be avoided and revision with ceramic bearings should be performed whenever possible.
Bibliography:ObjectType-Article-2
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ObjectType-Review-1
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2016.12.050