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Mid term results of total hip arthroplasty using polyethylene-ceramic composite (Sandwich) liner

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Abstract

Background: Ceramic-on-ceramic (COC) couplings are an attractive alternative bearing surfaces that have been reported to eliminate or reduce problems related to polyethylene wear debris. However, the material in total hip arthroplasty (THA) remains one of the major concern regarding the risk of fracture. The present study aims at reporting the fracture rate of bearings in a series of COC THAs with the use of a sandwich liner and attempt to detect the relative risk factors, the possible cause and assess the clinical results.

Materials and Methods: We retrospectively evaluated 153 patients (163 hips) using the sandwich liner COC THA between 2001 and 2009. Patient assessment was based on demographic factors, including age, weight, gender and body-mass index (BMI). All patients were evaluated clinically and radiographically or using computed tomography viz-a-viz dislocation, osteolysis, periprosthetic fracture, infection, loosening and implant fracture.

Results: Three ceramic sandwich liners fracture (1.84%) were observed at an average of 7.3 years’ followup. The factors which were found to be non-significant to the ceramic liner fracture, included age (P = 0.205), weight (P = 0.241), gender (P = 0.553), BMI (P = 0.736), inclination (P = 0.199) and anteversion (P = 0.223). The overall survival was 91.4% at 12-year with revision as the endpoint. Other complications included osteolysis in 4 (2.45%), dislocation in one and periprosthetic fracture in one. In no hip aseptic loosening of the implants was seen.

Conclusions: Our experience with the ceramic-polyethylene sandwich liner acetabular component has been disappointing because of the high rate of fracture and osteolyis. We have discontinued the use of this device and recommend the same.

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References

  1. Kress AM, Schmidt R, Holzwarth U, Forst R, Mueller LA. Excellent results with cementless total hip arthroplasty and alumina-on-alumina pairing: Minimum ten-year followup. Int Orthop 2011;35:195–200.

    Article  Google Scholar 

  2. Hamadouche M, Boutin P, Daussange J, Bolander ME, Sedel L. Alumina-on-alumina total hip arthroplasty: A minimum 18.5-year followup study. J Bone Joint Surg Am 2002;84-A:69–77.

    Article  Google Scholar 

  3. Hasegawa M, Sudo A, Uchida A. Alumina ceramic-on-ceramic total hip replacement with a layered acetabular component. J Bone Joint Surg Br 2006;88:877–82.

    Article  CAS  Google Scholar 

  4. Ravasi F, Sansone V. Five-year followup with a ceramic sandwich cup in total hip replacement. Arch Orthop Trauma Surg 2002;122:350–3.

    Article  CAS  Google Scholar 

  5. Park YS, Hwang SK, Choy WS, Kim YS, Moon YW, Lim SJ. Ceramic failure after total hip arthroplasty with an alumina-on-alumina bearing. J Bone Joint Surg Am 2006;88:780–7.

    PubMed  Google Scholar 

  6. Popescu D, Gallart X, Garcia S, Bori G, Tomas X, Riba J. Fracture of a ceramic liner in a total hip arthroplasty with a sandwich cup. Arch Orthop Trauma Surg 2008;128:783–5.

    Article  Google Scholar 

  7. Hasegawa M, Sudo A, Hirata H, Uchida A. Ceramic acetabular liner fracture in total hip arthroplasty with a ceramic sandwich cup. J Arthroplasty 2003;18:658–61.

    Article  Google Scholar 

  8. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: Treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51:737–55.

    Article  CAS  Google Scholar 

  9. Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg Br 1993;75:228–32.

    Article  CAS  Google Scholar 

  10. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 1978;60:217–20.

    Article  CAS  Google Scholar 

  11. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 1976:20–32.

    Google Scholar 

  12. Gruen TA, McNeice GM, Amstutz HC. Modes of failure of cemented stem-type femoral components: A radiographic analysis of loosening. Clin Orthop Relat Res 1979:17–27.

    Google Scholar 

  13. Sugano N, Takao M, Sakai T, Nishii T, Miki H, Ohzono K. Eleven-to 14-year followup results of cementless total hip arthroplasty using a third-generation alumina ceramic-on-ceramic bearing. J Arthroplasty 2012;27:736–41.

    Article  Google Scholar 

  14. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 1990:107–28.

    Google Scholar 

  15. Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 1973;55:1629–32.

    Article  CAS  Google Scholar 

  16. Boutin P. Total arthroplasty of the hip by fritted aluminum prosthesis. Experimental study and 1st clinical applications. Rev Chir Orthop Reparatrice Appar Mot 1972;58:229–46.

    CAS  PubMed  Google Scholar 

  17. Böhler M, Mochida Y, Bauer TW, Plenk H Jr, Salzer M. Wear debris from two different alumina-on-alumina total hip arthroplasties. J Bone Joint Surg Br 2000;82:901–9.

    Article  Google Scholar 

  18. Clarke IC, Good V, Williams P, Schroeder D, Anissian L, Stark A, et al. Ultra-low wear rates for rigid-on-rigid bearings in total hip replacements. Proc Inst Mech Eng H 2000;214:331–47.

    Article  CAS  Google Scholar 

  19. Ha YC, Kim SY, Kim HJ, Yoo JJ, Koo KH. Ceramic liner fracture after cementless alumina-on-alumina total hip arthroplasty. Clin Orthop Relat Res 2007;458:106–10.

    PubMed  Google Scholar 

  20. Kircher J, Bader R, Schroeder B, Mittelmeier W. Extremely high fracture rate of a modular acetabular component with a sandwich polyethylene ceramic insertion for THA: A preliminary report. Arch Orthop Trauma Surg 2009;129:1145–50.

    Article  Google Scholar 

  21. Barrack RL, Burak C, Skinner HB. Concerns about ceramics in THA. Clin Orthop Relat Res 2004:73–9.

    Google Scholar 

  22. Park MS, Yoon SJ, Yoo MJ. Repeated ceramic head fracture after ceramic-on-ceramic total hip arthroplasty. J Korean Hip Soc 2012;24:59–64.

    Article  Google Scholar 

  23. Poggie RA, Turgeon TR, Coutts RD. Failure analysis of a ceramic bearing acetabular component. J Bone Joint Surg Am 2007;89:367–75.

    Article  Google Scholar 

  24. Walter WL, Insley GM, Walter WK, Tuke MA. Edge loading in third generation alumina ceramic-on-ceramic bearings: Stripe wear. J Arthroplasty 2004;19:402–13.

    Article  Google Scholar 

  25. Elkins JM, Pedersen DR, Callaghan JJ, Brown TD. Do obesity and/or stripe wear increase ceramic liner fracture risk? An XFEM analysis. Clin Orthop Relat Res 2013;471:527–36.

    Article  Google Scholar 

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Author notes

  1. Tao Wang and Xi-Jiang Zhao contributed equally and therefore share first authorship

Authors and Affiliations

  1. Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, Jiangsu, 215006, P. R. China

    Tao Wang,  Jun-Ying Sun, Guo-Chun Zha, Sheng-Jie Dong & Xi-Jiang Zhao

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  1. Tao Wang
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  2. Jun-Ying Sun
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  3. Guo-Chun Zha
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Correspondence to Jun-Ying Sun.

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Wang, T., Sun, JY., Zha, GC. et al. Mid term results of total hip arthroplasty using polyethylene-ceramic composite (Sandwich) liner. IJOO 50, 10–15 (2016). https://doi.org/10.4103/0019-5413.173512

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  • DOI: https://doi.org/10.4103/0019-5413.173512

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