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The use of ceramic-on-ceramic bearings in isolated revision of the acetabular component.
MedLine Citation:
PMID:  23450016     Owner:  NLM     Status:  In-Data-Review    
The practice of removing a well-fixed cementless femoral component is associated with high morbidity. Ceramic bearing couples are low wearing and their use minimises the risk of subsequent further revision due to the production of wear debris. A total of 165 revision hip replacements were performed, in which a polyethylene-lined acetabular component was revised to a new acetabular component with a ceramic liner, while retaining the well-fixed femoral component. A titanium sleeve was placed over the used femoral trunnion, to which a ceramic head was added. There were 100 alumina and 65 Delta bearing couples inserted. The mean Harris hip score improved significantly from 71.3 (9.0 to 100.0) pre-operatively to 91.0 (41.0 to 100.0) at a mean follow up of 4.8 years (2.1 to 12.5) (p < 0.001). No patients reported squeaking of the hip. There were two fractures of the ceramic head, both in alumina bearings. No liners were seen to fracture. No fractures were observed in components made of Delta ceramic. At 8.3 years post-operatively the survival with any cause of failure as the endpoint was 96.6% (95% confidence interval (CI) 85.7 to 99.3) for the acetabular component and 94.0% (95% CI 82.1 to 98.4) for the femoral component. The technique of revising the acetabular component in the presence of a well-fixed femoral component with a ceramic head placed on a titanium sleeve over the used trunnion is a useful adjunct in revision hip practice. The use of Delta ceramic is recommended. Cite this article: Bone Joint J 2013;95-B:333-8.
C M Jack; D O Molloy; W L Walter; B A Zicat; W K Walter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The bone & joint journal     Volume:  95-B     ISSN:  2049-4408     ISO Abbreviation:  Bone Joint J     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101599229     Medline TA:  Bone Joint J     Country:  England    
Other Details:
Languages:  eng     Pagination:  333-8     Citation Subset:  AIM; IM    
Specialist Orthopaedic Group, Suite 1.08, 3-9 Gillies Street, North Sydney, New South Wales 2060, Australia.
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