Acta Scientific Orthopaedics (ISSN: 2581-8635)

Case Report Volume 5 Issue 11

A Cracking Tale of Ceramic Component Fracture Revision: A Case Report and Literature Review

Elliott A Ayling1*, Mohammed Amer2,3 and Douglas Dunlop2

1Department of Orthopaedics, University of Southampton, United Kingdom
2Department of Orthopaedics, University Hospital Southampton, United Kingdom
3Cairo University, Giza, Egypt

*Corresponding Author: Elliott A Ayling, Department of Orthopaedics, University of Southampton, United Kingdom.

Received: August 29, 2022; Published: October 12, 2022

Abstract

Ceramic-on-ceramic (CoC) hip replacements present a significant issue upon fracture. Remnant ceramic particulates can become embedded in polyethylene, leading to wear of revision bearings causing significant metallosis.
This article uses a case report and literature review to explore the limited evidence guiding revisions of ceramic component fracture. The literature search used pre-defined search terms to explore the databases of PubMed, Ovid MEDLINE, The Cochrane Library and Web of Science.
The case report outlines a gentleman with significant metallosis following revision of a CoC fracture to a MoP. The remaining ceramic ‘sand’ can embed in polyethylene, resulting in wear of the opposing bearing surface. Good outcomes are reported for ceramic-on-polyethylene (CoP) and CoC revisions. Disastrous outcomes are seen with metal heads. This is consistent with our findings, where the serum cobalt and chromium soared and a metallosis soup developed.
Improperly revised ceramic components can present a significant risk to patients. Metallic replacement for ceramic fracture is inappropriate due to the potential for runaway abrasive wear. A ceramic ball should be a prerequisite of any such revision. This is poorly documented in the literature, with a need for greater awareness.

Keywords: Total Hip Arthroplasty; Revision; Ceramic Head Fracturea

References

  1. Editorial Board NJR. “National Joint Registry 18th Annual Report”. In: Registry NJ, editor (2021).
  2. Merola M and Affatato S. “Materials for Hip Prostheses: A Review of Wear and Loading Considerations”. Materials 3 (2019).
  3. Sharma V., et al. “Revision Total Hip Arthroplasty for Ceramic Head Fracture A Long- Term Follow-Up”. Journal of Arthroplasty 3 (2010): 342-347.
  4. Zagra L., et al. “Revision of ceramic fracture with ceramic-on-polyethylene in total hip arthroplasty: Medium-term results”. Injury-International Journal of the Care of the Injured 47 (2016): S116-S20.
  5. C I., et al. “Revision Total Hip Arthroplasty after Ceramic Bearing Fractures in Patients Under 60- years Old; Mid-term Results”. Hip Pelvis (2018): 156-161.
  6. Traina MDF., et al. “Revision of ceramic hip replacements for fracture of a ceramic component: AAOS exhibit selection”. The Journal of Bone and Joint Surgery, Incorporated (2011): 1-9.
  7. Allain J., et al. “Revision total hip arthroplasty performed after fracture of a ceramic femoral head - A multicenter survivorship study”. Journal of Bone and Joint Surgery-American 5 (2003): 825-830.
  8. Park KS., et al. “Revision total hip arthroplasty with metal-on-metal bearing for ceramic bearing fractures”. Journal of Orthopaedic Science 3 (2019): 452-457.
  9. Trebse R., et al. “Results of revision of total hip arthroplasty for alumina ceramic-on-ceramic bearing fracture”. Hip International 3 (2016): 237-243.
  10. Koo KH., et al. “Revision of Ceramic Head Fracture After Third Generation Ceramic-on-Ceramic Total Hip Arthroplasty”. Journal of Arthroplasty 1 (2014): 214-218.
  11. Artiaco S., et al. “Metallosis in Sequelae of Prosthetic Revision for Ceramic Components Fracture: A Case Report with Clinical Presentation Mimicking Periprosthetic Hip Infection”. Joints (2021): 215-217.
  12. Zywiel MG., et al. “Fatal cardiomyopathy after revision total hip replacement for fracture of a ceramic liner”. Bone and Joint Journal 1 (2013): 31-37.

Citation

Citation: Elliott A Ayling., et al. “A Cracking Tale of Ceramic Component Fracture Revision: A Case Report and Literature Review". Acta Scientific Orthopaedics 5.11 (2022): 84-90.

Copyright

Copyright: © 2022 Elliott A Ayling., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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