Z Orthop Unfall 2018; 156(03): 272-280
DOI: 10.1055/s-0043-124767
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Ceramic-on-Ceramic in Total Hip Replacement Revision

Article in several languages: English | deutsch
Davide Cucchi
1   Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Germany
,
Martin Gathen
1   Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Germany
,
Robert Streicher
2   Dr. Streicher GmbH, Feusisberg, Switzerland
,
Dieter Christian Wirtz
1   Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
27 February 2018 (online)

Abstract

Background The use of Ceramic-on-Ceramic (CoC) bearings in primary total hip arthroplasty (THA) is increasing and has been intensively analysed. This bearing plays a particularly relevant role in young, active patients and shows advantages over other bearings in biocompatibility, wear rate and lubrication properties. On the contrary, CoC bearings in revision THA are seldom used and scarcely analysed. The aim of this study is to systematically review the available literature on CoC bearings in revision THA.

Methods A systematic research in the English literature was performed to identify all studies reporting results of THA revisions using ceramic-on-ceramic bearing. The initial search strategy revealed 555 articles for consideration. On the basis of eligibility criteria, 26 studies were included in this review.

Results Twenty-six studies, accounting for 1846 procedures, were eligible and included in the review. No studies of Level I were identified. Eighteen studies reported on revisions of CoC implants for various reasons, performed either with CoC or different bearings. In 111 patients a CoC bearing was used for the revision. Six studies consistently reported outcome measures for CoC bearing THA revisions, so that a quantitative synthesis of the data was possible. The range of follow-up across the six studies varied between 2.1 and 19 years, with a cumulative avearage follow-up of 9.3 years. A good functional result was documented, with a cumulative weighted mean for postoperative Harris Hip Score (HHS) of 87 points. The rate of dislocation in this group was 3.45% and the risk of fracture of an alumina ceramic head was 0.35% (1 study). Squeaking was reported as complication of CoC bearing THA revisions in three studies, with a calculated incidence of 0.52%.

Conclusion Modern CoC bearings show advantages in preclinical and retrospective studies over other bearings also in revision cases and are therefore to be considered a promising alternative for this kind of operation. Reasonable indications for CoC bearing in revision THA are revisions for aseptic loosening or recurrent dislocation in young patients, fractures of ceramic components, large acetabular defects or in patients that are allergic to bone cement components. Nevertheless, prospectively designed or randomized studies are lacking and needed to confirm CoC as optimal solution for revision THA cases.

 
  • References/Literatur

  • 1 National Joint Registry for England, Wales, Northern Ireland and the Isle of Man Editorial Board. 12th Annual Report 2015. Im Internet: http://www.njrcentre.org.uk/njrcentre/Portals/0/Documents/England/Reports/12th annual report/NJR Online Annual Report 2015.pdf; Stand: 19.06.2017
  • 2 Graves S. AOANJRR Committee. Australian Orthopaedic Association National Joint Registry: Annual Report 2015. Im Internet: https://aoanjrr.sahmri.com/de/annual-reports-2015 Stand: 19.06.2017
  • 3 Ong KL, Lau E, Suggs J. et al. Risk of subsequent revision after primary and revision total joint arthroplasty. Clin Orthop Relat Res 2010; 468: 3070-3076
  • 4 Khatod M, Cafri G, Inacio MCS. et al. Revision total hip arthroplasty: factors associated with re-revision surgery. J Bone Joint Surg Am 2015; 97: 359-366
  • 5 Graves S. AOANJRR Committee. Australian Orthopaedic Association National Joint Registry: Annual Report 2016. Im Internet: https://aoanjrr.sahmri.com/de/annual-reports-2016 Stand: 19.06.2017
  • 6 Kurtz SM, Lau EC, Baykal D. et al. Outcomes of ceramic bearings after revision total hip arthroplasty in the medicare population. J Arthroplasty 2016; 31: 1979-1985
  • 7 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: 229-246
  • 8 Mittelmeier H. [New development of wear-resistant ceramic and metal composite prostheses with ribbed support shafts for cement-free implantation]. Hefte Unfallheilkd 1975; 126: 333-336
  • 9 Buttaro MA, Zanotti G, Comba FM. et al. Primary total hip arthroplasty with fourth-generation ceramic-on-ceramic: analysis of complications in 939 consecutive cases followed for 2–10 years. J Arthroplasty 2016; 32: 480-486
  • 10 Sedel L. Evolution of alumina-on-alumina implants: a review. Clin Orthop Relat Res 2000; 379: 48-54
  • 11 Lee YK, Yoon BH, Choi YS. et al. Metal on metal or ceramic on ceramic for cementless total hip arthroplasty: a meta-analysis. J Arthroplasty 2016; 31: 2637-2645
  • 12 Smith AJ, Dieppe P, Vernon K. et al. Failure rates of stemmed metal-on-metal hip replacements: analysis of data from the National Joint Registry of England and Wales. Lancet 2012; 379: 1199-1204
  • 13 Cole JC, Lemons JE, Eberhardt AW. Gamma irradiation alters fatigue-crack behavior and fracture toughness in 1900H and GUR 1050 UHMWPE. J Biomed Mater Res 2002; 63: 559-566
  • 14 Baker DA, Hastings RS, Pruitt L. Study of fatigue resistance of chemical and radiation crosslinked medical grade ultrahigh molecular weight polyethylene. J Biomed Mater Res 1999; 46: 573-581
  • 15 Kim YH, Park JW, Kim JS. Isolated revision of an acetabular component to a ceramic-on-ceramic bearing in patients under 50 years of age. Bone Joint J 2015; 97-B: 1197-1203
  • 16 Pitto RP, Sedel L. Periprosthetic joint infection in hip arthroplasty: is there an association between infection and bearing surface type?. Clin Orthop Relat Res 2016; 474: 2213-2218
  • 17 Gallo J, Stewart T, Novotny R. et al. Early fracture of a plasma cup ceramic liner: a case report and surface analysis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2007; 151: 341-346
  • 18 Tso CY, Chiu KH, Cheung KW. Ceramic insert dislodgment after revision ceramic-on-ceramic total hip arthroplasty. J Arthroplasty 2010; 25: 660.e5-7
  • 19 Sariali E, Stewart T, Mamoudy P. et al. Undetected fracture of an alumina ceramic on ceramic hip prosthesis. J Arthroplasty 2010; 25: 658.e1-5
  • 20 Lee SC, Jung KA, Nam CH. et al. Acetabular screw head-induced ceramic acetabular liner fracture in cementless ceramic-on-ceramic total hip arthroplasty. Orthopedics 2010; DOI: 10.3928/01477447-20100329-30.
  • 21 Lee LH, Langton D, Green S. Adverse sequelae following revision of a total hip replacement for a fractured ceramic component: case report. SICOT-J 2015; 1: 28
  • 22 Shafafy R, Foote J, Hargrove R. A novel technique for identification of fractured ceramic acetabular liner in total hip arthroplasty: a case report. Hip Int 2016; 25: 492-494
  • 23 Hannouche D, Nich C, Bizot P. et al. Fractures of ceramic bearings: history and present status. Clin Orthop Relat Res 2003; 417: 19-26
  • 24 Allain J, Roudot-Thoraval F, Delecrin J. et al. Revision total hip arthroplasty performed after fracture of a ceramic femoral head. A multicenter survivorship study. J Bone Joint Surg Am 2003; 85-A: 825-830
  • 25 Traina F, Tassinari E, De Fine M. et al. Revision of ceramic hip replacements for fracture of a ceramic component: AAOS exhibit selection. J Bone Joint Surg Am 2011; 93: e147
  • 26 Koo KH, Ha YC, Kim SY. et al. Revision of ceramic head fracture after third generation ceramic-on-ceramic total hip arthroplasty. J Arthroplasty 2014; 29: 214-218
  • 27 Trebše R, Mihelič A, Levašič V. et al. Results of revision of total hip arthroplasty for alumina ceramic-on-ceramic bearing fracture. Hip Int 2016; 26: 237-243
  • 28 Schmidt-Braekling T, Renner L, Mintz DN. et al. Do changes in the production process affect the outcome of ceramic liners: a 3-year follow-up study. J Arthroplasty 2016; 32: 1314-1317
  • 29 Matharu GS, Daniel J, Ziaee H. et al. Failure of a novel ceramic-on-ceramic hip resurfacing prosthesis. J Arthroplasty 2015; 30: 416-418
  • 30 Hannouche D, Delambre J, Zadegan F. et al. Is there a risk in placing a ceramic head on a previously implanted trunion?. Clin Orthop Relat Res 2010; 468: 3322-3327
  • 31 Chana R, Facek M, Tilley S. et al. Ceramic-on-ceramic bearings in young patients: outcomes and activity levels at minimum ten-year follow-up. Bone Joint J 2013; 95-B: 1603-1609
  • 32 Seo BH, Ryu DJ, Kang JS. et al. Primary total hip arthroplasty using 3rd generation ceramic-on-ceramic articulation. Hip Int 2016; 26: 468-473
  • 33 Chang JD, Kamdar R, Yoo JH. et al. Third-generation ceramic-on-ceramic bearing surfaces in revision total hip arthroplasty. J Arthroplasty 2009; 24: 1231-1235
  • 34 Jack CM, Molloy DO, Walter WL. et al. The use of ceramic-on-ceramic bearings in isolated revision of the acetabular component. Bone Joint J 2013; 95-B: 333-338
  • 35 Yoo JJ, Yoon PW, Lee YK. et al. Revision total hip arthroplasty using an alumina-on-alumina bearing surface in patients with osteolysis. J Arthroplasty 2013; 28: 132-138
  • 36 Kim Y, Kim YH, Hwang KT. et al. Isolated acetabular revision with ceramic-on-ceramic bearings using a ceramic head with a metal sleeve. J Arthroplasty 2014; 29: 2420-2423
  • 37 Yang JH, Yang SJ, Kang JS. et al. Cementless revision total hip arthroplasty with ceramic articulation. Hip Pelvis 2015; 27: 223-231
  • 38 Wong JML, Liu YL, Graves S. et al. What is the rerevision rate after revising a hip resurfacing arthroplasty? Analysis from the AOANJRR. Clin Orthop Relat Res 2015; 473: 3458-3464
  • 39 Singh JA, Schleck C, Harmsen S. et al. Clinically important improvement thresholds for Harris Hip Score and its ability to predict revision risk after primary total hip arthroplasty. BMC Musculoskelet Disord 2016; 17: 256
  • 40 Hu D, Tie K, Yang X. et al. Comparison of ceramic-on-ceramic to metal-on-polyethylene bearing surfaces in total hip arthroplasty: a meta-analysis of randomized controlled trials. J Orthop Surg Res 2015; 10: 22
  • 41 Hernigou P, Homma Y, Pidet O. et al. Ceramic-on-ceramic bearing decreases the cumulative long-term risk of dislocation. Clin Orthop Relat Res 2013; 471: 3875-3882
  • 42 Guo L, Yang Y, An B. et al. Risk factors for dislocation after revision total hip arthroplasty: A systematic review and meta-analysis. Int J Surg 2016; 38: 123-129
  • 43 Hernigou P, Roussignol X, Delambre J. et al. Ceramic-on-ceramic THA associated with fewer dislocations and less muscle degeneration by preserving muscle progenitors. Clin Orthop Relat Res 2015; 473: 3762-3769
  • 44 Rimondini L, Cerroni L, Carrassi A. et al. Bacterial colonization of zirconia ceramic surfaces: an in vitro and in vivo study. Int J Oral Maxillofac Implants 2002; 17: 793-798
  • 45 Piconi C, Ionescu AC, Cochis A. et al. Bioceramic materials show reduced pathological biofilm formation. Key Eng Mater 2014; 631: 448-453
  • 46 Kunutsor SK, Whitehouse MR, Blom AW. et al. Re-infection outcomes following one- and two-stage surgical revision of infected hip prosthesis: a systematic review and meta-analysis. PLoS One 2015; 10: e0139166
  • 47 Wirtz DC. Ceramic-on-Ceramic in Revision Total Hip Arthroplasty. Kongressvortrag. Wien: Ceramtec Symposium, EFORT; 2017
  • 48 Ganzer D, Forke L, Irlenbusch U. Two-year follow-up of revision total hip arthroplasty using a ceramic revision head with a retained well-fixed femoral component: a case series. J Med Case Rep 2014; 8: 434
  • 49 de Thomasson E, Conso C, Mazel C. A well-fixed femoral stem facing a failed acetabular component: to exchange or not? A 5- to 15-year follow-up study. Orthop Traumatol Surg Res 2012; 98: 24-29
  • 50 Stathopoulos IP, Lampropoulou-Adamidou KI, Vlamis JA. et al. One-component revision in total hip arthroplasty: the fate of the retained component. J Arthroplasty 2014; 29: 2007-2012
  • 51 Helwig P, Konstantinidis L, Hirschmüller A. et al. Modular sleeves with ceramic heads in isolated acetabular cup revision in younger patients-laboratory and experimental analysis of suitability and clinical outcomes. Int Orthop 2013; 37: 15-19
  • 52 Preuss R, Haeussler KL, Flohr M. et al. Fretting corrosion and trunnion wear – is it also a problem for sleeved ceramic heads?. Semin Arthroplasty 2012; 23: 251-257
  • 53 Owen DH, Russell NC, Smith PN. et al. An estimation of the incidence of squeaking and revision surgery for squeaking in ceramic-on-ceramic total hip replacement: a meta-analysis and report from the Australian Orthopaedic Association National Joint Registry. Bone Joint J 2014; 96-B: 181-187
  • 54 Levy YD, Munir S, Donohoo S. et al. Review on squeaking hips. World J Orthop 2015; 6: 812-820
  • 55 Abdel MP, Heyse TJ, Elpers ME. et al. Ceramic liner fractures presenting as squeaking after primary total hip arthroplasty. J Bone Joint Surg Am 2014; 96: 27-31
  • 56 Sentürk U, Perka C. [Ceramic-on-ceramic bearings in total hip arthroplasty (THA)]. Z Orthop Unfall 2015; 153: 198-202
  • 57 Rambani R, Kepecs DM, Mäkinen TJ. et al. Revision total hip arthroplasty for fractured ceramic bearings: a review of best practices for revision cases. J Arthroplasty 2017; 32: 1959-1964
  • 58 Gozzini PA, Schmid C, Dalla Pria P. Massive wear in a CoCrMo head following the fracture of an alumina head. Hip Int 2008; 12: 37-42