Ceramic on ceramic total hip arthroplasty and liner fracture. Two case reports and review of literature.
Journal
Acta bio-medica : Atenei Parmensis
ISSN: 2531-6745
Titre abrégé: Acta Biomed
Pays: Italy
ID NLM: 101295064
Informations de publication
Date de publication:
05 12 2019
05 12 2019
Historique:
received:
20
10
2019
accepted:
23
10
2019
entrez:
11
12
2019
pubmed:
11
12
2019
medline:
18
11
2020
Statut:
epublish
Résumé
Ceramic on ceramic bearing surfaces in total hip arthroplasty are rising in number with the purpose of reducing debris osteolysis in young patients. New generation ceramics drastically reduced the well known problem of liner's fracture associated with this material but this still represents a complication. We present the only two cases of acetabular liner fracture we had in our department, on a total of 252 patients, since we use CoC bearing surfaces in THR (2005-2019) analyzing symptoms and causes of this complication. Review of recent literature focused on symptoms and causes of liners fracture, well matched our cases. In line with the analysis of literature, the major cause of liner fracture is neck-cup impingement resulting in the "edge-loading" effect, followed by other factors like prosthesis design, traumas and patient weight. From data also emerge the role of acoustic phenomena (e.g. squeaking) and CT scan in the diagnostic process. Last generation ceramics should be used in CoC THR, implant malposition and prosthesis design have a dominant role in liner fracture, squeaking should always be investigated. CT scan have an important role in diagnosis. Implant revision with substitution of the bearing surfaces is mandatory in case of fracture or impending fracture signs.
Sections du résumé
BACKGROUND AND AIM OF THE WORK
Ceramic on ceramic bearing surfaces in total hip arthroplasty are rising in number with the purpose of reducing debris osteolysis in young patients. New generation ceramics drastically reduced the well known problem of liner's fracture associated with this material but this still represents a complication.
METHODS
We present the only two cases of acetabular liner fracture we had in our department, on a total of 252 patients, since we use CoC bearing surfaces in THR (2005-2019) analyzing symptoms and causes of this complication. Review of recent literature focused on symptoms and causes of liners fracture, well matched our cases.
RESULTS
In line with the analysis of literature, the major cause of liner fracture is neck-cup impingement resulting in the "edge-loading" effect, followed by other factors like prosthesis design, traumas and patient weight. From data also emerge the role of acoustic phenomena (e.g. squeaking) and CT scan in the diagnostic process.
CONCLUSIONS
Last generation ceramics should be used in CoC THR, implant malposition and prosthesis design have a dominant role in liner fracture, squeaking should always be investigated. CT scan have an important role in diagnosis. Implant revision with substitution of the bearing surfaces is mandatory in case of fracture or impending fracture signs.
Identifiants
pubmed: 31821308
doi: 10.23750/abm.v90i12-S.8961
pmc: PMC7233715
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
192-195Références
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