An assessment of in vivo failures of alumina ceramic total hip joint replacements
Several cases of alumina ceramic hip replacement failures are reviewed fractographically. Three main findings are illustrated. Firstly, there is evidence that surgeons can damage the femoral head bore surface during surgery. Secondly, three of the failures described are of extended neck designs whic...
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| Vydané v: | Journal of the European Ceramic Society Ročník 32; číslo 12; s. 3073 - 3084 |
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| Jazyk: | English |
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Elsevier Ltd
01.09.2012
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| Abstract | Several cases of alumina ceramic hip replacement failures are reviewed fractographically. Three main findings are illustrated. Firstly, there is evidence that surgeons can damage the femoral head bore surface during surgery. Secondly, three of the failures described are of extended neck designs which are weaker than those of normal or short length in axial laboratory testing. Under physiological loading, such geometry can lead to levering forces, inappropriate localized contact with the metallic stem and stress concentrations. Delayed failure can ensue, with a fracture pattern quite different from that seen in conventional uniaxial testing. Thirdly, while some failures show head bore surfaces which are clean apart from metallic witness marking, others show brown stains and white deposits suggesting poor conformal contact. We suspect either stems become damaged during surgery before mounting the head or entrapment of debris, pointing to handling care and cleanliness varying between hospitals. |
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| AbstractList | Several cases of alumina ceramic hip replacement failures are reviewed fractographically. Three main findings are illustrated. Firstly, there is evidence that surgeons can damage the femoral head bore surface during surgery. Secondly, three of the failures described are of extended neck designs which are weaker than those of normal or short length in axial laboratory testing. Under physiological loading, such geometry can lead to levering forces, inappropriate localized contact with the metallic stem and stress concentrations. Delayed failure can ensue, with a fracture pattern quite different from that seen in conventional uniaxial testing. Thirdly, while some failures show head bore surfaces which are clean apart from metallic witness marking, others show brown stains and white deposits suggesting poor conformal contact. We suspect either stems become damaged during surgery before mounting the head or entrapment of debris, pointing to handling care and cleanliness varying between hospitals. |
| Author | Trebše, Rihard Danzer, Robert Morrell, Roger Milošev, Ingrid |
| Author_xml | – sequence: 1 givenname: Roger surname: Morrell fullname: Morrell, Roger email: Roger.Morrell@npl.co.uk organization: Materials Division, National Physical Laboratory, Teddington, Middlesex TW11 0LW, UK – sequence: 2 givenname: Robert surname: Danzer fullname: Danzer, Robert organization: Institut für Struktur und Funktionskeramik, Montanuniversität Leoben, Peter-Tunner-Strasse 5, A-8700 Leoben, Austria – sequence: 3 givenname: Ingrid surname: Milošev fullname: Milošev, Ingrid organization: Physical and Organic Chemistry Dept., Institut Jožef Stefan, Jamova 39, SI-1000 Ljubljana, Slovenia – sequence: 4 givenname: Rihard surname: Trebše fullname: Trebše, Rihard organization: Orthopaedic Hospital Valdoltra, Jadranska c. 31, SI-6280 Ankaran, Slovenia |
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| Cites_doi | 10.2106/JBJS.H.00867 10.1016/j.arth.2003.09.018 10.1016/S0142-9612(01)00206-X 10.4028/www.scientific.net/KEM.223.1 10.3928/0147-7447-19980201-11 10.1016/j.jeurceramsoc.2008.02.028 10.1016/j.ijrmhm.2010.02.009 10.1016/j.jeurceramsoc.2006.04.120 10.1243/PIME_PROC_1990_204_250_02 10.1002/adem.200700347 10.1097/00003086-200010000-00004 |
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| Title | An assessment of in vivo failures of alumina ceramic total hip joint replacements |
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