Liner dissociation in a large-diameter ceramic-bearing acetabular component: a report of five cases.
Ceramic liner
Dissociation
Monoblock acetabular component
Total hip arthroplasty
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
09 Feb 2022
09 Feb 2022
Historique:
received:
29
09
2021
accepted:
02
02
2022
entrez:
10
2
2022
pubmed:
11
2
2022
medline:
12
2
2022
Statut:
epublish
Résumé
Ceramic-on-ceramic (CoC) bearings for total hip arthroplasty (THA) have been offering very favorable results and survivorship since their introduction. In order to increase range of movement (ROM) and decrease dislocation rates, some manufacturers have introduced larger diameter head (LDH) CoC bearings. This has been achieved with the use of preassembled cup designs, in which the ceramic liner is already fitted into the metal backing and implanted as a monoblock component by the surgeon. In this report we present data from a series of 5 patients with ceramic liner dissociation from a monoblock cup. All cases were overweight men with acetabular components of 56 or 58 mm. After a mean of 5.5 (range, 3.5-6.7) years, all patients reported sudden pain and audible noise when performing activities of daily living. Liner displacement was suspected on plain radiographs and confirmed by Ct-scan. Pneumarthrosis was present in all cases. Taper modular junction wear and corrosion signs were observed in the four revised patients. Although one of our case is still treated conservatively, implant revision is probably inevitable. Further LDH CoC implant design should take in consideration this potential complication by avoiding bearing diameters over 40mm and/or improving locking mechanism or by providing a real monoblock acetabular implant.
Sections du résumé
BACKGROUND
BACKGROUND
Ceramic-on-ceramic (CoC) bearings for total hip arthroplasty (THA) have been offering very favorable results and survivorship since their introduction. In order to increase range of movement (ROM) and decrease dislocation rates, some manufacturers have introduced larger diameter head (LDH) CoC bearings. This has been achieved with the use of preassembled cup designs, in which the ceramic liner is already fitted into the metal backing and implanted as a monoblock component by the surgeon. In this report we present data from a series of 5 patients with ceramic liner dissociation from a monoblock cup.
CASE PRESENTATION
METHODS
All cases were overweight men with acetabular components of 56 or 58 mm. After a mean of 5.5 (range, 3.5-6.7) years, all patients reported sudden pain and audible noise when performing activities of daily living. Liner displacement was suspected on plain radiographs and confirmed by Ct-scan. Pneumarthrosis was present in all cases. Taper modular junction wear and corrosion signs were observed in the four revised patients.
CONCLUSION
CONCLUSIONS
Although one of our case is still treated conservatively, implant revision is probably inevitable. Further LDH CoC implant design should take in consideration this potential complication by avoiding bearing diameters over 40mm and/or improving locking mechanism or by providing a real monoblock acetabular implant.
Identifiants
pubmed: 35139828
doi: 10.1186/s12891-022-05082-6
pii: 10.1186/s12891-022-05082-6
pmc: PMC8829977
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
136Informations de copyright
© 2022. The Author(s).
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