ABSTRACT
PURPOSE: Although advances in technology have reduced the risk of ceramic implant fractures in total hip arthroplasty, these injuries do occur and their treatment remains challenging. There is a lack of studies reporting on the effectiveness of ceramic components in revision hip arthroplasty after ceramic bearing fracture. The aim of this study is to evaluate clinical and radiologic outcomes of revision surgery with ceramic-on-ceramic components after ceramic bearing fractures in young (i.e., under 60 years old) and active patients. MATERIALS AND METHODS: Eight patients who, from May 2004 to November 2011, underwent ceramic-on-ceramic revision surgery following a ceramic component fracture and had more than 6 years follow up were enrolled in this study. All eight patients were male with mean ages at first and revision surgeries of 39 years (range, 31–50 years) and 43.8 years (range, 33–60 years), respectively. There were 6 and 2 cases of ceramic liner and ceramic head fractures, respectively. The average time from the first operation to revision surgery was 54.3 months (range, 9–120 months), and the average follow up period was 9.7 years (range, 6–13.3 years). RESULTS: At the last follow up, all patients showed improvement in Harris hip score and pain relief and there were no cases of loosening or osteolysis. CONCLUSION: Revision total hip arthroplasty using ceramic-on-ceramic components after ceramic component fracture is a feasible and appropriate surgical option in young and active patients.
Subject(s)
Humans , Male , Arthroplasty , Arthroplasty, Replacement, Hip , Ceramics , Follow-Up Studies , Head , Hip , Hip Prosthesis , OsteolysisABSTRACT
Objective@#To investigate the failure reasons of all-ceramic restorations fabricated with chair-side CAD-CAM technology (CEREC®) and to improve the clinical survival of all-ceramic restorations. @*Methods @#All-ceramic single-tooth restorations of CEREC® in stomatology hospital of Jiangsu province between 2013 and 2016 were summarized. By clinical examination and CEREC Biogeneric surveying, the failure reasons and related restoration types were evaluated. These results were analyzed with Chi-square test and Spearman correlation analysis. @*Results@#A total of 61 cases with restoration types of 11 inlays, 38 onlays, 2 endocrowns, and 11 all-crowns, resulted in a failure rate of 5.4% in all-ceramic single-tooth restorations in 1-4 years follow-up. The reasons for failure included ceramic fracture (n=33), debonding (n=13), tooth fracture (n=15), which attributed to thin ceramic thickness (n=27), acute line angle (n=6), insufficient enamel bulk (n=3), insufficient retention type (n=10), insufficient resistance type (n=15).@*Conclusion @# The most common reason for failure in CEREC® restorations was insufficient preparation space in occlusal surface.
ABSTRACT
Popularity of ceramic materials has increased among joint reconstruction surgeons for treatment of young patients who wish to maintain their active lifestyle. However, ceramic fracture is one of the most serious complications, and there are many concerns regarding the acceleration of third body wear and refracture of ceramic articulation after revision total hip arthroplasty for a ceramic fracture. To date, a few authors have reported on complications due to residual ceramic particles after revision surgery. We report on a case of metallosis due to metal head wear caused by residue of fractured ceramic particles lodged in the polyethylene liner after revision total hip arthroplasty for a ceramic liner fracture.