Sandwich type ceramic liner fracture rate with the Atlas III™ socket: A study of 144 primary total hip replacements at a mean 74 months’ follow-up - 31/08/11
, S. Guériot b, O. Boniface a, J.-Y. Deladerrière a, S. Luneau a, C. Maynou a
Corresponding author. Tel.: +00 33 6 76 74 49 88.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Summary |
Introduction |
Ceramic friction bearings have been proposed as a means of reducing wear in total hip replacement (THR). A “sandwich” composite concept including a ceramic bearing surface has been proposed as simplifying the modularity while matching metal-back cups with a polyethylene liner. It is not precisely known how frequently abnormal noise would occur during functioning of this type of implant, which moreover entails a risk of ceramic liner fracture.
Hypothesis |
Results with sandwich type ceramic liners are comparable to those with polyethylene liners, without risk of side effects (noise, fracture).
Patients and methods |
Clinical and radiological results of 144 cementless Atlas III™ cups containing a 28mm-diameter polyethylene-ceramic sandwich type liner coupled to a ceramic Biolox Forte™ head were retrospectively analyzed at a mean 74months’ follow-up. Mean patient age was 59.4 years. Twelve patients were lost to follow-up. Femoral components comprised 61 ESOP™ anatomic stems and 71 BHS™ Corail stems. The radiologic study used Imagika™ software.
Results |
Global function scores were satisfactory: PMA score, 17.2±1.2 (range, 9 to 18); global Harris score, 93.6±3.1 (49 to 100). Global survivorship was 91.6% (95% CI: 86.34-96.9). Radioclinical analysis found seven liner fractures (5.3%) at a mean 32months; all were non-traumatic and asymptomatic. Clinical risk factors for liner fracture were overweight, advanced age, dislocation, prosthetic impingement, increased postoperative offset was a radiologic risk factor.
Discussion and conclusion |
Despite these satisfactory radioclinical results, matching those for metal-backed implants containing a polyethylene liner, close surveillance is mandatory with this type of composite implant. The high fracture rate with ceramic-polyethylene sandwich type liners and relative lack of symptoms warrant caution in their use.
Level of evidence |
Level IV, retrospective or historic series.
Le texte complet de cet article est disponible en PDF.Keywords : Hip, Arthroplasty, Ceramic sandwich, Fracture, Component breakage, Squeaking
Plan
Vol 97 - N° 5
P. 494-500 - septembre 2011 Retour au numéro
Article précédent
- De Quervain’s disease treatment using partial resection of the extensor retinaculum: A short-term results survey
- M.A. Altay, C. Erturk, U.E. Isikan
- Total hip arthroplasty dislocation rate following isolated cup revision using Hueter’s direct anterior approach on a fracture table
- A. Cogan, S. Klouche, P. Mamoudy, E. Sariali
Bienvenue sur EM-consulte, la référence des professionnels de santé.